Myo-inositol for Reduction of Insulin Therapy in Gestational Diabetes Mellitus

NCT ID: NCT03875755

Last Updated: 2025-12-29

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

1080 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-04

Study Completion Date

2027-01-20

Brief Summary

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Gestational diabetes mellitus (GDM) is defined as hyperglycemia first-diagnosed during pregnancy. Glycemic control reduces GDM-related complications. With the new diagnostic criteria of GDM, up to 25% of pregnant women have GDM, whereas it was previously 6-10% in France. Therefore caring for women with GDM is very time-consuming. Therapeutic strategy includes dietary and lifestyle measures and additional insulin therapy for 15 to 40% of the women with GDM if the glycemic targets are not achieved after a period of 1 to 2 weeks of diet. Insulin therapy is imperfect for the following main reasons: need for education (i.e. subcutaneous administration, dose titration), hypoglycemia and weight gain, limited acceptance and high cost. Psychosocial deprivation is associated with more cases of GDM and health accessibility may be unequal.

MYO-INOSITOL (MI) is an oral dietary supplement, which reduces insulin resistance. Women with GDM are deficient in MI. MI supplementation safely prevents GDM by 65 to 87% in high-risk women. A pilot study has shown a 75% reduction of the need for insulin during GDM not controlled by diet.

The coordinator investigator propose here, for the first time, a randomized controlled study evaluating MI versus placebo in women with newly diagnosed GDM.

Detailed Description

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Prospective, multicenter, superiority, randomised, double blind study with two arms.

1. In the 23 participating centers selection of women with GDM between 6 to 37 (+6 days) amenorrhea weeks
2. Explanation of protocol, with signature of consent in case of acceptation.
3. Randomization

* Experimental group: The women will receive 2 caps of MI with acid folic a day, until delivery
* Control group: The women will receive 2 caps of placebo (containing only acid folic) a day, until delivery

In both arms, the participants will be routinely followed up during pregnancy:
* diet education,
* self-monitoring of blood glucose before and after meals
* and during follow-up insulin therapy if glucose value targets are unmet
4. Routine monitoring of the women with GDM in both arms, up to delivery, without use of other oral hypoglycemic agents during pregnancy.

At delivery:
* MI (or placebo) will be stopped
* Events during pregnancy will be collected
5. Last visit three months after delivery. Oral glucose tolerance test, anthropometric measures for women and their child.

Conditions

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Gestational Diabetes Mellitus

Keywords

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Diabetes Pregnancy MYO-INOSITOL Oral supplementation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Double blind

Study Groups

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Myo Inositol

The women will receive 2 caps of Myo Inositol with acid folic a day, until delivery

Group Type EXPERIMENTAL

Myo Inositol

Intervention Type DIETARY_SUPPLEMENT

One soft gel capsule containing MI 600 mg and folic acid 200 μg twice a day, until delivery.

Placebo

The women will receive 2 caps of placebo (acid folic) a day, until delivery

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

One soft gel capsule of placebo (folic acid 200 μg) twice a day until delivery.

Interventions

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Myo Inositol

One soft gel capsule containing MI 600 mg and folic acid 200 μg twice a day, until delivery.

Intervention Type DIETARY_SUPPLEMENT

Placebo

One soft gel capsule of placebo (folic acid 200 μg) twice a day until delivery.

Intervention Type OTHER

Other Intervention Names

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INOFOLIC

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years
* Singleton pregnancy
* GDM diagnosed during pregnancy according to IADPSG (International Association of the Diabetes and Pregnancy Study Groups) criteria, i.e.

* fasting plasma glucose between 92 mg/dL (5.1 mmol/L) and 125 mg/dL (6.9 mmol/L)
* and/or 1-hour plasma glucose value after 75 g oral glucose tolerance test (OGTT) ≥ 180 mg/dL (10.0 mmol/L)
* and/or 2-hour plasma glucose value between 153 mg/dL (8.5 mmol/L) and 199 mg/dL ((11.0 mmol/L)
* or overt diabetes according to 2-hours post OGTT plasma glucose value ≥ 200 mg/dl
* 6 to 37 (+6 days) amenorrhea weeks at the time of randomization
* Capacity for self-monitoring of blood glucose
* Signed informed consent

Exclusion Criteria

* Insulin use before randomization during this pregnancy
* Use of other oral hypoglycemic agents during this pregnancy
* Long time corticosteroid treatment
* Pre-existing diabetes before pregnancy
* Overt diabetes diagnosed during pregnancy according to fasting plasma glucose ≥ 126 mg/dL (7 mmol/l)
* Lack of Social Insurance
* Insufficient French understanding and speaking
* Participant in another investigational drug study at inclusion visit
* Fetal malformation diagnosed by previous fetal ultrasound
* Personal history of any bariatric surgery
* Hypersensitivity to any ingredient of dietary supplement formulation
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assistance Publique - Hôpitaux de Paris

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emmanuel COSSON, MD-PhD

Role: PRINCIPAL_INVESTIGATOR

Assistance Publique - Hôpitaux de Paris

Locations

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Hôpital Avicenne

Bobigny, , France

Site Status

Hopital Avicenne

Bobigny, , France

Site Status

Countries

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France

References

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Unfer V, Carlomagno G, Dante G, Facchinetti F. Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials. Gynecol Endocrinol. 2012 Jul;28(7):509-15. doi: 10.3109/09513590.2011.650660. Epub 2012 Feb 1.

Reference Type BACKGROUND
PMID: 22296306 (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)

D'Anna R, Di Benedetto V, Rizzo P, Raffone E, Interdonato ML, Corrado F, Di Benedetto A. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol. 2012 Jun;28(6):440-2. doi: 10.3109/09513590.2011.633665. Epub 2011 Nov 28.

Reference Type BACKGROUND
PMID: 22122627 (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)

Matarrelli B, Vitacolonna E, D'Angelo M, Pavone G, Mattei PA, Liberati M, Celentano C. Effect of dietary myo-inositol supplementation in pregnancy on the incidence of maternal gestational diabetes mellitus and fetal outcomes: a randomized controlled trial. J Matern Fetal Neonatal Med. 2013 Jul;26(10):967-72. doi: 10.3109/14767058.2013.766691. Epub 2013 Mar 1.

Reference Type BACKGROUND
PMID: 23327487 (View on PubMed)

D'Anna R, Scilipoti A, Giordano D, Caruso C, Cannata ML, Interdonato ML, Corrado F, Di Benedetto A. myo-Inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care. 2013 Apr;36(4):854-7. doi: 10.2337/dc12-1371. Epub 2013 Jan 22.

Reference Type BACKGROUND
PMID: 23340885 (View on PubMed)

D'Anna R, Di Benedetto A, Scilipoti A, Santamaria A, Interdonato ML, Petrella E, Neri I, Pintaudi B, Corrado F, Facchinetti F. Myo-inositol Supplementation for Prevention of Gestational Diabetes in Obese Pregnant Women: A Randomized Controlled Trial. Obstet Gynecol. 2015 Aug;126(2):310-315. doi: 10.1097/AOG.0000000000000958.

Reference Type BACKGROUND
PMID: 26241420 (View on PubMed)

Lubin V, Shojai R, Darmon P, Cosson E. A pilot study of gestational diabetes mellitus not controlled by diet alone: First-line medical treatment with myoinositol may limit the need for insulin. Diabetes Metab. 2016 Jun;42(3):192-5. doi: 10.1016/j.diabet.2016.01.005.

Reference Type BACKGROUND
PMID: 26948394 (View on PubMed)

Other Identifiers

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P160940J

Identifier Type: -

Identifier Source: org_study_id