Inositol Stereoisomers to Treat Gestational Diabetes

NCT ID: NCT02097069

Last Updated: 2014-03-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-30

Brief Summary

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The investigators aim to compare the effect of different inositol stereoisomers supplementation in lowering insulin resistance levels after 8 weeks of treatment in pregnant women with GDM and in preventing adverse obstetric outcomes.

The study population includes 80 women with GDM, randomly allocated to subgroup A (folic acid 400 mcg/day), subgroup B (myo-inositol 2000 mg twice a day), subgroup C (D-chiro-inositol 250 mg twice a day), and subgroup D (Myo-inositol plus D-chiro-inositol 550mg/13,8 mg twice a day).

Folic acid or inositol stereoisomers will be administered starting at the enrolling time (24-28 week gestation, after GDM diagnosis) till the delivery.

The homeostasis model assessment of insulin resistance (HOMA-IR) and the sensitivity index (QUICKI) will be checked at the moment of the diagnostic oral glucose tolerance test (24-28 weeks) and after 8 weeks of treatment. Obstetric outcomes, the rate of women needed insulin therapy and insulin dosage will be registered.

Detailed Description

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Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy (1). It is characterized by an increase of physiological insulin resistance and it is associated with an increased risk of perinatal and maternal morbidity (2,3).

Inositol is a six-carbon polyol, normally present in a variety of foods, which has been classified as an insulin sensitizing agent. It exists as nine different isomers including myo-inositol (MI) and D-chiro-inositol (DCI) that are the most represented in human body. Myo-inositol and D-chiro-inositol glycans administration has been reported to exert beneficial effects at metabolic, hormonal and ovarian levels (4-5).

Recently has been demonstrated that Myo-inositol supplementation improves insulin resistance in patients with GDM (6), whereas there aren't data about the use of D-chiro-inositol or Myo-inositol plus D-chiro-inositol in women affected by GDM.

In this proposed study, the investigators aim to compare the effect of different inositol stereoisomers supplementation (Myo-inositol, D-chiro-inositol or Myo-inositol plus D-chiro-inositol ) in lowering insulin resistance levels after 8 weeks of treatment in pregnant women with GDM and in preventing adverse obstetric outcomes. All the available inositol formulations also contain folic acid (200 mcg).

The study population includes 80 women with GDM, randomly allocated to subgroup A (folic acid 400 mcg/day), subgroup B (myo-inositol 2000 mg twice a day), subgroup C (D-chiro-inositol 250 mg twice a day), and subgroup D (Myo-inositol plus D-chiro-inositol 550mg/13,8 mg twice a day).

Dietary control, folic acid or inositol stereoisomers will be administered starting at the enrolling time (24-28 week gestation, after GDM diagnosis) till the delivery.

The homeostasis model assessment of insulin resistance (HOMA-IR) and the sensitivity index (QUICKI) will be checked at the moment of the diagnostic oral glucose tolerance test (24-28 weeks) and after 8 weeks of treatment. Obstetric outcomes, the rate of women needed insulin therapy and insulin dosage will be registered.

Conditions

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Gestational Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Subgroup A

folic acid 400 mcg/day

Group Type OTHER

Folic acid

Intervention Type DIETARY_SUPPLEMENT

Folic acid 400 mcg/day

Subgroup B

myo-inositol 2000 mg twice a day

Group Type EXPERIMENTAL

Myo-inositol

Intervention Type DIETARY_SUPPLEMENT

myo-inositol 2000 mg twice a day

Subgroup C

D-chiro-inositol 250 mg twice a day

Group Type EXPERIMENTAL

D-Chiro-inositol

Intervention Type DIETARY_SUPPLEMENT

D-chiro inositol 250 mg twice a day

Subgroup D

Myo-inositol plus D-chiro inositol 550mg/13,8 mg twice a day

Group Type EXPERIMENTAL

Myo-inositol plus D-chiro inositol

Intervention Type DIETARY_SUPPLEMENT

Myo-inositol plus D-chiro inositol 550mg/13,8 mg twice a day

Interventions

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Folic acid

Folic acid 400 mcg/day

Intervention Type DIETARY_SUPPLEMENT

Myo-inositol

myo-inositol 2000 mg twice a day

Intervention Type DIETARY_SUPPLEMENT

D-Chiro-inositol

D-chiro inositol 250 mg twice a day

Intervention Type DIETARY_SUPPLEMENT

Myo-inositol plus D-chiro inositol

Myo-inositol plus D-chiro inositol 550mg/13,8 mg twice a day

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Gestational Diabetes diagnosed within 24-28 weeks gestation
* Caucasian pregnant women

Exclusion Criteria

* Pre-pregnancy diabetes
* Non-singleton pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Università degli Studi 'G. d'Annunzio' Chieti e Pescara

OTHER

Sponsor Role lead

Responsible Party

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Ester Vitacolonna

Professor Ester Vitacolonna

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hospital "SS Annunziata"

Chieti, Chieti, Italy

Site Status

Countries

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Italy

Facility Contacts

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Ester Vitacolonna, Professor

Role: primary

+393398073446

References

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Metzger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop-Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care. 1998 Aug;21 Suppl 2:B161-7. No abstract available.

Reference Type BACKGROUND
PMID: 9704245 (View on PubMed)

Casey BM, Lucas MJ, Mcintire DD, Leveno KJ. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol. 1997 Dec;90(6):869-73. doi: 10.1016/s0029-7844(97)00542-5.

Reference Type BACKGROUND
PMID: 9397092 (View on PubMed)

Jovanovic L, Pettitt DJ. Gestational diabetes mellitus. JAMA. 2001 Nov 28;286(20):2516-8. doi: 10.1001/jama.286.20.2516. No abstract available.

Reference Type BACKGROUND
PMID: 11722247 (View on PubMed)

Nestler JE, Jakubowicz DJ, Reamer P, Gunn RD, Allan G. Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome. N Engl J Med. 1999 Apr 29;340(17):1314-20. doi: 10.1056/NEJM199904293401703.

Reference Type BACKGROUND
PMID: 10219066 (View on PubMed)

Croze ML, Soulage CO. Potential role and therapeutic interests of myo-inositol in metabolic diseases. Biochimie. 2013 Oct;95(10):1811-27. doi: 10.1016/j.biochi.2013.05.011. Epub 2013 Jun 10.

Reference Type BACKGROUND
PMID: 23764390 (View on PubMed)

Corrado F, D'Anna R, Di Vieste G, Giordano D, Pintaudi B, Santamaria A, Di Benedetto A. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med. 2011 Aug;28(8):972-5. doi: 10.1111/j.1464-5491.2011.03284.x.

Reference Type BACKGROUND
PMID: 21414183 (View on PubMed)

Fraticelli F, Celentano C, Zecca IA, Di Vieste G, Pintaudi B, Liberati M, Franzago M, Di Nicola M, Vitacolonna E. Effect of inositol stereoisomers at different dosages in gestational diabetes: an open-label, parallel, randomized controlled trial. Acta Diabetol. 2018 Aug;55(8):805-812. doi: 10.1007/s00592-018-1157-4. Epub 2018 May 17.

Reference Type DERIVED
PMID: 29774465 (View on PubMed)

Other Identifiers

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VITA01

Identifier Type: -

Identifier Source: org_study_id

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