Different Effects of Inositol Stereoisomers on Insulin Sensitivity in Women With Gestational Diabetes
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 80
- 试验地点
- 2
- 主要终点
- Insulin resistance level evaluated by homeostasis model assessment of insulin resistance (HOMA-IR)
研究概览
简要总结
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.
详细描述
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).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Gestational Diabetes diagnosed within 24-28 weeks gestation
- •Caucasian pregnant women
排除标准
- •Pre-pregnancy diabetes
- •Non-singleton pregnancy
研究组 & 干预措施
Subgroup D
Myo-inositol plus D-chiro inositol 550mg/13,8 mg twice a day
干预措施: Myo-inositol plus D-chiro inositol (Dietary Supplement)
结局指标
主要结局
Insulin resistance level evaluated by homeostasis model assessment of insulin resistance (HOMA-IR)
时间窗: 56 days- 8 weeks
次要结局
- neonatal hypoglycemia(at delivery)
- cesarean section(at delivery)
- macrosomia(at delivery)
- hypertensive disorders(56 days- 8 weeks)
- jaundice requiring phototherapy(within the first 2 weeks after delivery)
- lipid profile(56 days- 8 weeks)
- insulin therapy requirements(56 days- 8 weeks)
研究者
Ester Vitacolonna
Professor Ester Vitacolonna
Università degli Studi 'G. d'Annunzio' Chieti e Pescara