Science Update

Myo-inositol and D-chiro-inositol help prevent gestational diabetes and macrosomia in newborns


According to a new study published last week in BioMedical Reports researchers demonstrated that myo-inositol combined with D-chiro-inositol helps prevent gestational diabetes and macrosomia in newborns in at risk women.

Oral hypoglycemics are recommended for controlling hyperglycemia in pregnant women; however these drugs have been associated with adverse effects such as neonatal hypoglycemia and teratogenicity with placental transfer to the fetus.

Inositol acts as second messenger which regulates several hormones such as follicle stimulating hormone thyroid stimulating hormone and insulin.

Studies have shown that an inositol deficiency is common in women with insulin resistance. There appears to be a reduced ability to process metabolize and effectively use inositol from foods which is a distinctive characteristic feature of insulin resistance. As a result the nutritional requirements of these patients may not be met by a simple change in the diet and that inositol should be viewed as a conditionally essential nutrient in these women.

This new study included a total of 83 pregnant women. Forty women were given 250 mg/day of D-chiro-inositol 1.75 g/day myo-inositol 12.5 mg/day zinc 10 mg/d methylsulfonylmethane and 400 mcg/day 5-MTHF and the other 43 women supplemented only with folate.

There was no statistical difference at baseline between two groups in relation to age body mass index (BMI) blood pressure fasting blood sugar HbA1c and hemoglobin levels.

After 24 weeks of pregnancy the incidence of gestational diabetes included 18 women in the folate only group and 5 women in the inositol group. In addition there was a significant differ­ence between the inositol and folate only groups for the risk of macrosomia.

Myo-inositol and D-chiro-inositol are both essential for patients with insulin resistance. The conversion of myo-inositol to D-chiro-inositol is of interest because errors here have been strongly involved in these patients. Strong evidence supports that the body makes D-chiro-inositol from myo-inositol and more evidence suggests that some people are less able to make this conversion than others.  Along this spectrum people who are completely unable to convert myo-inositol to D-chiro-inositol are only going to benefit from supplementation with D-chiro-inositol. Other people who make the conversion but with less than optimal efficiency may benefit from large doses of myo-inositol. And other individuals in between might see the best results from a blend of the two. Since this conversion is impaired in individuals with PCOS it is important to always include D-chiro-inositol with myo-inositol supplementation. D-chiro-inositol is the more potent form of inositol for supporting insulin resistance however myo-inositol is need for oocyte quality and maturation. Therefore supplementing with D-chiro-inositol alone cannot not fulfill myo-inositols roles that are specific and different from D-chiro-inositol since it does not convert to myo-inositol.

In addition essential fatty acids should be considered as most individuals with insulin resistance are deficient in these critical nutrients. Fish oils not only help with overall health but also help to improve insulin sensitivity and reduce inflammation.

By Michael Jurgelewicz DC DACBN DCBCN CNS

Source: DelEdera D Sarlo F et al. The influence of D-chiro-inositol and D-myo-inositol in pregnant women with glucose intolerance. BioMedical Reports 2017 August; 7(2): 169-172. DOI: 10.3892/br.2017.939

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