Science Update

Recent Review Explores Role of Inositol and Probiotics in Gestational Diabetes

Gestational diabetes mellitus (GDM) is a condition associated with abnormal glucose metabolism that first presents during pregnancy. Healthy nutrient levels during pregnancy may help support fetal development and the health of the birth parent. Recent research also indicates that certain nutrients may support healthy glucose metabolism during pregnancy. A recently published review by Vitacolonna and colleagues explored the potential supportive role of inositol and probiotics in the presence of GDM.  

Inositol is a molecule found in most vegetable and animal cells and is closely related to B vitamins. It is part of the structure of cellular membranes and is also important for lipid transport and many signaling pathways. Its derivatives have been shown to support the structure and proliferation of cells. Inositol has also been shown to support healthy glucose metabolism.  

The study by Vitacolonna and colleagues explores research on two derivatives of inositol: myo-inositol (MI) and D-chiro inositol (DCI). The urinary excretion of MI and DCI has been observed to be higher in individuals with GDM during early pregnancy when compared to those without GDM. Clinical studies suggest that supplementation with MI early in pregnancy may prevent the onset of GDM. Supplementation with MI has also been shown to support normal fetal development in studies. A study involving supplementation with MI plus folic acid during early pregnancy was associated with a reduction of the incidence of GDM in individuals associated with a higher risk. A pilot study explored the impact of MI supplementation in those affected by GDM and found improvements in glucose variability and mean glucose levels.  

DCI may also support healthy metabolism. Decreases in chiro-inositol and mediators associated with chiro-inositol have been associated with type 2 diabetes mellitus (T2DM). DCI has been shown in studies to help support the function, size, and differentiation of adipocytes.  

Vitacolonna and colleagues also explored the role of probiotics in GDM. Several large studies, including a Cochrane review, showed no statistically significant improvements in parameters associated with GDM in the presence of probiotic supplementation. Some smaller studies reported less pronounced improvements; one study reported non-statistically significant improvements in certain parameters related to glucose metabolism in the presence of probiotic supplementation in GDM. One double-blind, randomized control trial assessed the effects of supplementation with Bifidobacterium and Lactobacillus on individuals with GDM in late-second and early-third trimesters. In this study, there were statistically significant improvements in fasting plasma glucose and fasting plasma insulin after 4 weeks of supplementation with probiotics.  

Further research is needed on this topic before more conclusions can be drawn. However, the study by Vitacolonna and colleagues shows promise that certain nutraceuticals, such as inositol, may support the healthy glucose metabolism of individuals with GDM. 

By Colleen Ambrose, ND, MAT