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Licensed Unlicensed Requires Authentication Published by De Gruyter September 17, 2019

Non-pharmacological management of gestational diabetes: The role of myo-inositol

  • Federica Di Guardo ORCID logo EMAIL logo , Jessica Marika Currò , Gaetano Valenti , Paola Rossetti , Luisa Maria Di Gregorio , Francesca Conway , Benito Chiofalo , Simone Garzon ORCID logo , Simone Bruni and Gianluca Rizzo


Gestational diabetes mellitus (GDM) is the most common metabolic disorder occurring in pregnancy.

GDM plays an important role in the current diabetes epidemic: exposure to a high glycemic environment during the early stages of development increases the risk of the fetus to develop type two diabetes mellitus (T2DM) in adult life.

Various cardiometabolic risk factors are linked to GDM. A thorough knowledge of the risk factors and genes involved in the development of GDM, along with an understanding of the underlying pathophysiological mechanisms are crucial to properly identify patients at risk of developing this condition. There is growing evidence showing that myo-inositol, combined with an appropriate therapeutic regimen for GDM, can provide additional benefits to the patient. The aim of this review is to analyze the role of inositol isomers – especially myo-inositol (MYO-INS) – in the treatment of patients with GDM.



  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: None declared.


[1] Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 2018;138:271–81.10.1016/j.diabres.2018.02.023Search in Google Scholar PubMed

[2] World Health Organization & International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. Geneva: World Health Organization, 2006.Search in Google Scholar

[3] Nejentsev S, Howson JM, Walker NM, Szeszko J, Field SF, Stevens HE, et al. Localization of type 1 diabetes susceptibility to the MHC class I genes HLA-B and HLA-A. Nature 2007;450:887–92.10.1038/nature06406Search in Google Scholar PubMed PubMed Central

[4] Malandrino N, Smith RJ. Personalized medicine in diabetes. Clin Chem 2011;57:231–40.10.1373/clinchem.2010.156901Search in Google Scholar PubMed

[5] Reusch JE, Manson JE. Management of type 2 diabetes in 2017: getting to goal. JAMA 2017;317:1015–16.10.1001/jama.2017.0241Search in Google Scholar PubMed PubMed Central

[6] American Diabetes Association. Standards of medical care in diabetes - 2017. Diabetes Care 2017;40:S33–43.10.2337/dc17-S007Search in Google Scholar PubMed

[7] Vitale SG, Laganà AS, Nigro A, La Rosa VL, Rossetti P, Rapisarda AM, et al. Peroxisome proliferator-activated receptor modulation during metabolic diseases and cancers: master and minions. PPAR Res 2016;2016:6517313.10.1155/2016/6517313Search in Google Scholar PubMed PubMed Central

[8] Laganà AS, Vitale SG, Nigro A, Sofo V, Salmeri FM, Rossetti P, et al. Pleiotropic actions of Peroxisome Proliferator-Activated Receptors (PPARs) in dysregulated metabolic homeostasis, inflammation and cancer: current evidence and future perspectives. Int J Mol Sci 2016;17. in Google Scholar PubMed PubMed Central

[9] Scollan-Koliopoulos M, Guadagno S, Walker EA. Gestational diabetes management: guidelines to a healthy pregnancy. Nurse Pract 2006;31:14–23.10.1097/00006205-200606000-00004Search in Google Scholar PubMed

[10] Landon MB, Gabbe SG. Gestational diabetes mellitus. Obstet Gynecol 2011;118:1379–93.10.1097/AOG.0b013e31823974e2Search in Google Scholar PubMed

[11] Kühl C. Etiology and pathogenesis of gestational diabetes. Diabetes Care 1998;21:B19–26.Search in Google Scholar

[12] Albrecht SS, E V K, Bansil P, Jamieson DJ, Whiteman MK, Kourtis AP, et al. Diabetes trends among delivery hospitalizations in the U.S., 1994–2004. Diabetes Care 2010;33:768–73.10.2337/dc09-1801Search in Google Scholar PubMed PubMed Central

[13] DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis 2014;11:130415.10.5888/pcd11.130415Search in Google Scholar PubMed PubMed Central

[14] Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstet Gynecol Clin North Am 2007;34:173–99.10.1016/j.ogc.2007.03.002Search in Google Scholar PubMed PubMed Central

[15] Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A. Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care 2012;35:1492–8.10.2337/dc11-2267Search in Google Scholar PubMed PubMed Central

[16] Bener A, Saleh NM, Al-Hamaq A. Prevalence of gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Womens Health 2011;3:367–73.10.2147/IJWH.S26094Search in Google Scholar PubMed PubMed Central

[17] Chamberlain C, McNamara B, Williams ED, Yore D, Oldenburg B, Oats J, et al. Diabetes in pregnancy among indigenous women in Australia, Canada, New Zealand and the United States. Diabetes Metab Res Rev 2013;29:241–56.10.1002/dmrr.2389Search in Google Scholar PubMed PubMed Central

[18] Abell SK, De Courten B, Boyle JA, Teede HJ. Inflammatory and other biomarkers: role in pathophysiology and prediction of gestational diabetes mellitus. Int J Mol Sci 2015;16:13442–73.10.3390/ijms160613442Search in Google Scholar PubMed PubMed Central

[19] Williams MA, Qiu C, Muy-Rivera M, Vadachkoria S, Song T, Luthy DA. Plasma adiponectin concentrations in early pregnancy and subsequent risk of gestational diabetes mellitus. J Clin Endocrinol Metab 2004;89:2306–11.10.1210/jc.2003-031201Search in Google Scholar PubMed

[20] Ranheim T, Haugen F, Staff AC, Braekke K, Harsem NK, Drevon CA. Adiponectin is reduced in gestational diabetes mellitus in normal weight women. Acta Obstet Gynecol Scand 2004;83:341–7.10.1111/j.0001-6349.2004.00413.xSearch in Google Scholar PubMed

[21] Bao W, Baecker A, Song Y, Kiely M, Liu S, Zhang C. Adipokine levels during the first or early second trimester of pregnancy and subsequent risk of gestational diabetes mellitus: A systematic review. Metabolism 2015;64:756–64.10.1016/j.metabol.2015.01.013Search in Google Scholar PubMed PubMed Central

[22] Briana DD, Malamitsi-Puchner A. Reviews: adipocytokines in normal and complicated pregnancies. Reprod Sci 2009;16:921–37.10.1177/1933719109336614Search in Google Scholar PubMed

[23] Kinalski M, Telejko B, Kuźmicki M, Kretowski A, Kinalska I. Tumor necrosis factor alpha system and plasma adiponectin concentration in women with gestational diabetes. Horm Metab Res 2005;37:450–4.10.1055/s-2005-870238Search in Google Scholar PubMed

[24] Xu J, Zhao YH, Chen YP, Yuan XL, Wang J, Zhu H, et al. Maternal circulating concentrations of tumor necrosis factor-alpha, leptin, and adiponectin in gestational diabetes mellitus: a systematic review and meta-analysis. Sci World J 2014;2014:926932.10.1155/2014/926932Search in Google Scholar PubMed PubMed Central

[25] Asemi Z, Jazayeri S, Najafi M, Samimi M, Shidfar F, Tabassi Z, et al. Association between markers of systemic inflammation, oxidative stress, lipid profiles, and insulin resistance in pregnant women. ARYA Atheroscler 2013;9:172–8.Search in Google Scholar

[26] Jahromi AS, Zareian P, Madani A. Association of insulin resistance with serum interleukin-6 and TNF-α levels during normal pregnancy. Biomark Insights 2011;6:1–6.10.4137/BMI.S6150Search in Google Scholar PubMed PubMed Central

[27] Atègbo JM, Grissa O, Yessoufou A, Hichami A, Dramane KL, Moutairou K, et al. Modulation of adipokines and cytokines in gestational diabetes and macrosomia. J Clin Endocrinol Metab 2006;91:4137–43.10.1210/jc.2006-0980Search in Google Scholar PubMed

[28] Kuzmicki M, Telejko B, Szamatowicz J, Zonenberg A, Nikolajuk A, Kretowski A, et al. High resistin and interleukin-6 levels are associated with gestational diabetes mellitus. Gynecol Endocrinol 2009;25:258–63.10.1080/09513590802653825Search in Google Scholar PubMed

[29] Morisset AS, Dubé MC, Côté JA, Robitaille J, Weisnagel SJ, Tchernof A. Circulating interleukin-6 concentrations during and after gestational diabetes mellitus. Acta Obstet Gynecol Scand 2011;90:524–30.10.1111/j.1600-0412.2011.01094.xSearch in Google Scholar PubMed

[30] Hassiakos D, Eleftheriades M, Papastefanou I, Lambrinoudaki I, Kappou D, Lavranos D, et al. Increased maternal serum interleukin-6 concentrations at 11 to 14 weeks of gestation in low risk pregnancies complicated with gestational diabetes mellitus: development of a prediction model. Horm Metab Res 2016;48:35–41.10.1055/s-0034-1395659Search in Google Scholar PubMed

[31] Teh WT, Teede HJ, Paul E, Harrison CL, Wallace EM, Allan C. Risk factors for gestational diabetes mellitus: implications for the application of screening guidelines Aust N Z J Obstet Gynaecol 2011;51:26–30.10.1111/j.1479-828X.2011.01292.xSearch in Google Scholar PubMed

[32] Hedderson MM, Williams MA, Holt VL, Weiss NS, Ferrara A. Body mass index and weight gain prior to pregnancy and risk of gestational diabetes mellitus. Am J Obstet Gynecol 2008;198:409.e1–7.10.1016/j.ajog.2007.09.028Search in Google Scholar PubMed PubMed Central

[33] Lo JC, Feigenbaum SL, Escobar GJ, Yang J, Crites YM, Ferrara A. Increased prevalence of gestational diabetes mellitus among women with diagnosed polycystic ovary syndrome: a population-based study. Diabetes Care 2006;29:1915–17.10.2337/dc06-0877Search in Google Scholar PubMed

[34] Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr 2011;94:1975S–1979S.10.3945/ajcn.110.001032Search in Google Scholar

[35] Bodén R, Lundgren M, Brandt L, Reutfors J, Kieler H. Antipsychotics during pregnancy: relation to fetal and maternal metabolic effects. Arch Gen Psychiatry 2012;69:715–21.10.1001/archgenpsychiatry.2011.1870Search in Google Scholar

[36] Vitale SG, Laganà AS, Muscatello MR, La Rosa VL, Currò V, Pandolfo G, et al. Psychopharmacotherapy in pregnancy and breastfeeding Obstet Gynecol Surv 2016;71:721–33.10.1097/OGX.0000000000000369Search in Google Scholar

[37] Fisher JE, Smith RS, Lagrandeur R, Lorenz RP. Gestational diabetes mellitus in women receiving beta-adrenergics and corticosteroids for threatened preterm delivery. Obstet Gynecol 1997;90:880–3.10.1016/S0029-7844(97)00544-9Search in Google Scholar

[38] Kubo A, Ferrara A, Brown SD, Ehrlich SF, Tsai AL, Quesenberry CP, et al. Perceived psychosocial stress and gestational weight gain among women with gestational diabetes. PLoS One 2017;12:e0174290.10.1371/journal.pone.0174290Search in Google Scholar PubMed PubMed Central

[39] Jiwani A, Marseille E, Lohse N, Damm P, Hod M, Kahn JG. Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Fetal Neonatal Med 2012;25:600–10.10.3109/14767058.2011.587921Search in Google Scholar PubMed

[40] Buckley BS, Harreiter J, Damm P, Corcoy R, Chico A, Simmons D, et al. Gestational diabetes mellitus in Europe: prevalence, current screening practice and barriers to screening. Rev Diabet Med 2012;29:844–54.10.1111/j.1464-5491.2011.03541.xSearch in Google Scholar PubMed

[41] O’Sullivan JB, Mahan CM. Criteria for oral glucose tolerance test in pregnancy. Diabetes 1964;13:278–85.Search in Google Scholar

[42] Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes Care 2007;30:S251–60.10.2337/dc07-s225Search in Google Scholar PubMed

[43] HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008;358:1991–2002.10.1056/NEJMoa0707943Search in Google Scholar PubMed

[44] International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010;33:676–82.10.2337/dc10-0719Search in Google Scholar

[45] Weinert LS. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the international association of diabetes and pregnancy study groups consensus panel. Diabetes Care 2010;33:e97.10.2337/dc10-0544Search in Google Scholar PubMed

[46] Jenum AK, Mørkrid K, Sletner L, Vangen S, Vange S, Torper JL, et al. Impact of ethnicity on gestational diabetes identified with the WHO and the modified international association of diabetes and pregnancy study groups criteria: a population-based cohort study. Eur J Endocrinol 2012;166:317–24.10.1530/EJE-11-0866Search in Google Scholar PubMed PubMed Central

[47] Liao S, Mei J, Song W, Liu Y, Tan YD, Chi S, et al. The impact of the International Association of Diabetes and Pregnancy Study Groups (IADPSG) fasting glucose diagnostic criterion on the prevalence and outcomes of gestational diabetes mellitus in Han Chinese women. Diabet Med 2014;31:341–51.10.1111/dme.12349Search in Google Scholar PubMed

[48] Ryan EA. Diagnosing gestational diabetes. Diabetologia 2011;54:480–6.10.1007/s00125-010-2005-4Search in Google Scholar PubMed PubMed Central

[49] Cundy T, Ackermann E, Ryan EA. Gestational diabetes: new criteria may triple the prevalence but effect on outcomes is unclear. BMJ 2014;348:g1567–g1567.10.1136/bmj.g1567Search in Google Scholar PubMed

[50] Moyer VA. U.S. preventive services task force. Screening for gestational diabetes mellitus: U.S. preventive services task force recommendation statement. Ann Intern Med 2014;160:414–20.10.7326/M13-2905Search in Google Scholar PubMed

[51] López Stewart G. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract 2014;103:341–63.10.1016/j.diabres.2013.10.012Search in Google Scholar PubMed

[52] American Diabetes Association. Executive summary: Standards of medical care in diabetes–2014. Diabetes Care 2014;37:S5–13.10.2337/dc14-S005Search in Google Scholar PubMed

[53] Blumer I, Hadar E, Hadden DR, Jovanovič L, Mestman JH, Murad MH, et al. Diabetes and pregnancy: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4227–49.10.1210/jc.2013-2465Search in Google Scholar PubMed PubMed Central

[54] Zhu WW, Yang HX, Wei YM, Yan J, Wang ZL, Li XL, et al. Evaluation of the value of fasting plasma glucose in the first prenatal visit to diagnose gestational diabetes mellitus in china. Diabetes Care 2013;36:586–90.10.2337/dc12-1157Search in Google Scholar PubMed PubMed Central

[55] Moses RG, Calvert D. Pregnancy outcomes in women without gestational diabetes mellitus related to the maternal glucose level. Is there a continuum of risk? Diabetes Care 1995;18:1527–33.10.2337/diacare.18.12.1527Search in Google Scholar PubMed

[56] Salman H, Shah M, Ali A, Aziz A, Vitale SG. Assessment of relationship of serum neurokinin-B level in the pathophysiology of pre-eclampsia: A case–control study. Adv Ther 2018;35:1114–21.10.1007/s12325-018-0723-zSearch in Google Scholar PubMed

[57] Barden A, Singh R, Walters BN, Ritchie J, Roberman B, Beilin LJ. Factors predisposing to pre-eclampsia in women with gestational diabetes. J Hypertens 2004;22:2371–8.10.1097/00004872-200412000-00020Search in Google Scholar PubMed

[58] Esakoff TF, Rad S, Burwick RM, Caughey AB. Predictors of eclampsia in California. J Matern Fetal Neonatal Med 2016;29:1531–5.Search in Google Scholar

[59] Lykke JA, Langhoff-Roos J, Sibai BM, Funai EF, Triche EW, Paidas MJ. Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother. Hypertens 2009;53:944–51.10.1161/HYPERTENSIONAHA.109.130765Search in Google Scholar PubMed

[60] Laganà AS, Vitale SG, Sapia F, Valenti G, Corrado F, Padula F, et al. miRNA expression for early diagnosis of preeclampsia onset: hope or hype? J Matern Neonatal Med 2018;31:817–21.10.1080/14767058.2017.1296426Search in Google Scholar PubMed

[61] Laganà AS, Giordano D, Loddo S, Zoccali G, Vitale SG, Santamaria A, et al. Decreased Endothelial Progenitor Cells (EPCs) and increased Natural Killer (NK) cells in peripheral blood as possible early markers of preeclampsia: a case-control analysis. Arch Gynecol Obstet 2017;295:867–72.10.1007/s00404-017-4296-xSearch in Google Scholar PubMed

[62] Billionnet C, Mitanchez D, Weill A, Nizard J, Alla F, Hartemann A, et al. Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia 2017;60:636–44.10.1007/s00125-017-4206-6Search in Google Scholar PubMed PubMed Central

[63] Fadl HE, Ostlund IK, Magnuson AF, Hanson US. Maternal and neonatal outcomes and time trends of gestational diabetes mellitus in Sweden from 1991 to 2003. Diabet Med 2010;27:436–41.10.1111/j.1464-5491.2010.02978.xSearch in Google Scholar PubMed

[64] Krishnaveni GV, Veena SR, Hill JC, Kehoe S, Karat SC, Fall CH. Intrauterine exposure to maternal diabetes is associated with higher adiposity and insulin resistance and clustering of cardiovascular risk markers in Indian children. Diabetes Care 2010;33:402–4.10.2337/dc09-1393Search in Google Scholar PubMed PubMed Central

[65] Wu CS, Nohr EA, Bech BH, Vestergaard M, Olsen J. Long-term health outcomes in children born to mothers with diabetes: a population-based cohort study. PLoS One 2012;7:e36727.10.1371/journal.pone.0036727Search in Google Scholar PubMed PubMed Central

[66] Pantzartzis KA, Manolopoulos PP, Paschou SA, Kazakos K, Kotsa K, Goulis DG. Gestational diabetes mellitus and quality of life during the third trimester of pregnancy. Qual Life Res 2019;28:1349–54.10.1007/s11136-018-2090-2Search in Google Scholar PubMed

[67] Varela P, Spyropoulou AC, Kalogerakis Z, Vousoura E, Moraitou M, Zervas IM. Association between gestational diabetes and perinatal depressive symptoms: evidence from a Greek cohort study. Prim Health Care Res Dev 2017;18:441–7.10.1017/S1463423617000317Search in Google Scholar PubMed

[68] Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, et al. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med 2005;352:2477–86.10.1056/NEJMoa042973Search in Google Scholar PubMed

[69] Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med 2009;361:1339–48.10.1056/NEJMoa0902430Search in Google Scholar PubMed PubMed Central

[70] Hartling L, Dryden DM, Guthrie A, Muise M, Vandermeer B, Donovan L. Benefits and harms of treating gestational diabetes mellitus: A systematic review and meta-analysis for the U.S. preventive services task force and the national institutes of health office of medical applications of research. Ann Intern Med 2013;159:123–9.10.7326/0003-4819-159-2-201307160-00661Search in Google Scholar PubMed

[71] Kim C. Gestational diabetes: risks, management, and treatment options. Int J Womens Health 2010;2:339–51.10.2147/IJWH.S13333Search in Google Scholar PubMed PubMed Central

[72] Magee MS, Knopp RH, Benedetti TJ. Metabolic effects of 1200-kcal diet in obese pregnant women with gestational diabetes. Diabetes 1990;39:234–40.10.2337/diab.39.2.234Search in Google Scholar PubMed

[73] Algert S, Shragg P, Hollingsworth DR. Moderate caloric restriction in obese women with gestational diabetes. Obstet Gynecol 1985;65:487–91.Search in Google Scholar

[74] ACOG Committee on Practice Bulletins. ACOG practice bulletin. clinical management guidelines for obstetrician-gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. Obstet Gynecol 2005;105:675–85.10.1097/00006250-200503000-00049Search in Google Scholar PubMed

[75] Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition during pregnancy: part I weight gain: part II nutrient supplements. Washington (DC): National Academies Press (US), 1990.Search in Google Scholar

[76] Langford A, Joshu C, Chang JJ, Myles T, Leet T. Does gestational weight gain affect the risk of adverse maternal and infant outcomes in overweight women? Matern Child Health J 2011;15:860–5.10.1007/s10995-008-0318-4Search in Google Scholar PubMed

[77] Cheng YW, Chung JH, Kurbisch-Block I, Inturrisi M, Shafer S, Caughey AB. Gestational weight gain and gestational diabetes mellitus: perinatal outcomes. Obstet Gynecol 2008;112:1015–22.10.1097/AOG.0b013e31818b5dd9Search in Google Scholar PubMed

[78] Horton ES. Exercise in the treatment of NIDDM. Applications for GDM? Diabetes 1991;40:175–8.10.2337/diab.40.2.S175Search in Google Scholar

[79] de Barros MC, Lopes MA, Francisco RPV, Sapienza AD, Zugaib M. Resistance exercise and glycemic control in women with gestational diabetes mellitus. Am J Obstet Gynecol 2010;203:556.e1–6.10.1016/j.ajog.2010.07.015Search in Google Scholar

[80] Magnus P, Trogstad L, Owe KM, Olsen SF, Nystad W. Recreational physical activity and the risk of preeclampsia: a prospective cohort of Norwegian women. Am J Epidemiol 2008;168:952–7.10.1093/aje/kwn189Search in Google Scholar

[81] Sorensen TK, Williams MA, Lee I-M, Dashow EE, Thompson ML, Luthy DA. Recreational physical activity during pregnancy and risk of preeclampsia. Hypertens 2003;41:1273–80.10.1161/01.HYP.0000072270.82815.91Search in Google Scholar

[82] Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American college of sports medicine and the American diabetes association: joint position statement. Diabetes Care 2010;33:e147–67.10.2337/dc10-9990Search in Google Scholar

[83] ACOG technical bulletin. Diabetes and pregnancy. Number 200–December 1994 (replaces No. 92, May 1986). Committee on technical bulletins of the American College of obstetricians and gynecologists. Int J Gynaecol Obstet 1995;48:331–9.10.1016/0020-7292(95)90312-7Search in Google Scholar

[84] Hawkins JS, Casey BM, Lo JY, Moss K, McIntire DD, Leveno KJ. Weekly compared with daily blood glucose monitoring in women with diet-treated gestational diabetes. Obstet Gynecol 2009;113:1307–12.10.1097/AOG.0b013e3181a45a93Search in Google Scholar PubMed

[85] de Veciana M, Major CA, Morgan MA, Asrat T, Toohey JS, Lien JM, et al. Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl J Med 1995;333:1237–41.10.1056/NEJM199511093331901Search in Google Scholar PubMed

[86] Yu F, Lv L, Liang Z, Wang Y, Wen J, Lin X, et al. Continuous glucose monitoring effects on maternal glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus: a prospective cohort study. J Clin Endocrinol Metab 2014;99:4674–82.10.1210/jc.2013-4332Search in Google Scholar PubMed

[87] Coustan DR, Imam K. Gestational diabetes mellitus. Clin Chem 2013;59:24–34.10.1373/clinchem.2013.203331Search in Google Scholar PubMed

[88] Committee on Practice Bulletins—Obstetrics. ACOG practice bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol 2018;131:e49–64.10.1097/AOG.0000000000002501Search in Google Scholar

[89] Van Assche FA, Gepts W. The cytological composition of the foetal endocrine pancreas in normal and pathological conditions. Diabetologia 1971;7:434–44.10.1007/BF01212059Search in Google Scholar

[90] Galjaard S, Devlieger R, Van Assche FA. Fetal growth and developmental programming. J Perinat Med 2013;41:101–5.10.1515/jpm-2012-0020Search in Google Scholar

[91] Van Assche FA. Symmetric and asymmetric fetal macrosomia in relation to long-term consequences. Am J Obstet Gynecol 1997;177:1563–4.10.1016/S0002-9378(97)70126-1Search in Google Scholar

[92] Chiofalo B, Laganà AS, Vaiarelli A, La Rosa VL, Rossetti D, Palmara V, et al. Do miRNAs play a role in fetal growth restriction? A fresh look to a busy corner. Biomed Res Int 2017;2017:6073167.10.1155/2017/6073167Search in Google Scholar PubMed PubMed Central

[93] Padula F, Laganà AS, Vitale SG, Giorlandino C. Comment on “Customized fetal growth charts for parents” characteristics, race, and parity by quantile regression analysis: a cross-sectional multicenter italian study. J Ultrasound Med 2016;35:855.10.7863/ultra.16.01008Search in Google Scholar PubMed

[94] Cignini P, Laganà AS, Retto A, Vitale SG. Knotting on heaven’s door: 3D color Doppler ultrasound imaging of a true cord knot. Arch Gynecol Obstet 2016;293:1357–8.10.1007/s00404-016-4084-zSearch in Google Scholar PubMed

[95] O’Connor C, Doolan A, O’Higgins A, Segurado R, Sheridan-Pereiraet M, Turner MJ, et al. Fetal subcutaneous tissue measurements in pregnancy as a predictor of neonatal total body composition. Prenat Diagn 2014;34:952–5.10.1002/pd.4400Search in Google Scholar PubMed

[96] Maso G, Piccoli M, Parolin S, Restaino S, Alberico S. Diabetes in pregnancy: timing and mode of delivery. Curr Diab Rep 2014;14:506.10.1007/s11892-014-0506-0Search in Google Scholar PubMed

[97] Vitale SG, Marilli I, Rapisarda AM, Rossetti D, Belluomo G, Iapichino V, et al. Cellular and biochemical mechanisms, risk factors and management of preterm birth: state of the art. Minerva Ginecol 2014;66:589–95.Search in Google Scholar

[98] Royal College of Obstetricians and Gynaecologists. Shoulder Dystocia (Green-top Guideline No. 42). RCOG Press, 2012.Search in Google Scholar

[99] Witkop CT, Neale D, Wilson LM, Bass EB, Nicholson WK. Active compared with expectant delivery management in women with gestational diabetes: a systematic review. Obstet Gynecol 2009;113:206–17.10.1097/AOG.0b013e31818db36fSearch in Google Scholar PubMed

[100] Vitale SG, Marilli I, Rapisarda AM, Iapichino V, Stancanelli F, Cianci A. Diagnosis, antenatal surveillance and management of prolonged pregnancy: current perspectives. Minerva Ginecol 2015;67:365–73.Search in Google Scholar

[101] Jovanovic L. Glucose and insulin requirements during labor and delivery: the case for normoglycemia in pregnancies complicated by diabetes. Endocr Pract 2004;10:40–5.10.4158/EP.10.S2.40Search in Google Scholar

[102] Yasuhi I, Soda T, Yamashita H, Urakawa A, Izumi M, Kugishima Y, et al. The effect of high-intensity breastfeeding on postpartum glucose tolerance in women with recent gestational diabetes. Int Breastfeed J 2017;12:32.10.1186/s13006-017-0123-zSearch in Google Scholar

[103] Caruso S, Cianci S, Vitale SG, Fava V, Cutello S, Cianci A. Sexual function and quality of life of women adopting the levonorgestrel-releasing intrauterine system (LNG-IUS 13.5 mg) after abortion for unintended pregnancy. Eur J Contracept Reprod Heal Care 2018;23:24–31.10.1080/13625187.2018.1433824Search in Google Scholar

[104] Rosenthal EW, Easter SR, Morton-Eggleston E, Dutton C, Zera C. Contraception and postpartum follow-up in patients with gestational diabetes. Contraception 2017;95:431–3.10.1016/j.contraception.2016.11.001Search in Google Scholar

[105] Chiofalo B, Laganà AS, Imbesi G, Vitale SG, Catena U, Campolo F, et al. Is oral contraceptive-induced headache dependent on patent foramen ovale? Clinical dynamics, evidence-based hypothesis and possible patient-oriented management. Med Hypotheses 2016;94:86–8.10.1016/j.mehy.2016.07.003Search in Google Scholar

[106] Lopez LM, Grimes DA, Schulz KF. Steroidal contraceptives: effect on carbohydrate metabolism in women without diabetes mellitus. Cochrane Database Syst Rev 2012;CD006133.10.1002/14651858.CD006133.pub4Search in Google Scholar

[107] O’Brien SH, Koch T, Vesely SK, Schwarz EB. Hormonal contraception and risk of thromboembolism in women with diabetes. Diabetes Care 2017;40:233–8.10.2337/dc16-1534Search in Google Scholar

[108] Bonomo M, Cetin I, Pisoni MP, Faden D, Mion E, Taricco E, et al. Flexible treatment of gestational diabetes modulated on ultrasound evaluation of intrauterine growth: a controlled randomized clinical trial. Diabetes Metab 2004;30:237–44.10.1016/S1262-3636(07)70114-3Search in Google Scholar

[109] Kjos SL, Schaefer-Graf U, Sardesi S, Peters RK, Buley A, Xiang AH, et al. A randomized controlled trial using glycemic plus fetal ultrasound parameters versus glycemic parameters to determine insulin therapy in gestational diabetes with fasting hyperglycemia. Diabetes Care 2001;24:1904–10.10.2337/diacare.24.11.1904Search in Google Scholar PubMed

[110] Balsells M, García-Patterson A, Gich I, Corcoy R. Ultrasound-guided compared to conventional treatment in gestational diabetes leads to improved birthweight but more insulin treatment: systematic review and meta-analysis. Acta Obstet Gynecol Scand 2014;93:144–51.10.1111/aogs.12291Search in Google Scholar PubMed

[111] Mathiesen ER, Hod M, Ivanisevic M, Duran Garcia S, Brøndsted L, Jovanovic L, et al. Maternal efficacy and safety outcomes in a randomized, controlled trial comparing insulin detemir with NPH insulin in 310 pregnant women with type 1 diabetes. Diabetes Care 2012;35:2012–17.10.2337/dc11-2264Search in Google Scholar PubMed PubMed Central

[112] Price N, Bartlett C, Gillmer M. Use of insulin glargine during pregnancy: a case-control pilot study. BJOG 2007;114:453–7.10.1111/j.1471-0528.2006.01216.xSearch in Google Scholar PubMed

[113] Durnwald CP, Landon MB. A comparison of lispro and regular insulin for the management of type 1 and type 2 diabetes in pregnancy. J Matern Fetal Neonatal Med 2008;21:309–13.10.1080/14767050802022797Search in Google Scholar PubMed

[114] Gui J, Liu Q, Feng L. Metformin vs insulin in the management of gestational diabetes: a meta-analysis. PLoS One 2013;8:e64585.10.1371/journal.pone.0064585Search in Google Scholar PubMed PubMed Central

[115] Rowan JA, Hague WM, Gao W, Battin MR, Moore MP. MiG trial investigators. Metformin versus insulin for the treatment of gestational diabetes. N Engl J Med 2008;358:2003–15.10.1056/NEJMoa0707193Search in Google Scholar PubMed

[116] Committee on Practice Bulletins–Obstetrics. Practice bulletin No. 137: Gestational diabetes mellitus. Obstet Gynecol 2013;122:406–16.10.1097/01.AOG.0000433006.09219.f1Search in Google Scholar PubMed

[117] Zeng Y, Li M, Chen Y, Jiang L, Wang S, Mo X, et al. The use of glyburide in the management of gestational diabetes mellitus: a meta-analysis. Adv Med Sci 2014;59:95–101.10.1016/j.advms.2014.03.001Search in Google Scholar PubMed

[118] Wang Y, Storlien LH, Jenkins AB, Tapsell LC, Jin Y, Pan JF, et al. Dietary variables and glucose tolerance in pregnancy. Diabetes Care 2000;23:460–4.10.2337/diacare.23.4.460Search in Google Scholar PubMed

[119] Bo S, Menato G, Lezo A, Signorile A, Bardelli C, De Michieli F, et al. Dietary fat and gestational hyperglycaemia. Diabetologia 2001;44:972–8.10.1007/s001250100590Search in Google Scholar PubMed

[120] Carey VJ, Walters EE, Colditz GA, Solomon CG, Willett WC, Rosner BA, et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses’ Health Study. Am J Epidemiol 1997;145:614–19.10.1093/oxfordjournals.aje.a009158Search in Google Scholar PubMed

[121] Zhang C, Schulze MB, Solomon CG, Hu FB. A prospective study of dietary patterns, meat intake and the risk of gestational diabetes mellitus. Diabetologia 2006;49:2604–13.10.1007/s00125-006-0422-1Search in Google Scholar PubMed

[122] Zhang C. Risk factors for gestational diabetes: from an epidemiological standpoint. Gestation. Diabetes dur. after pregnancy. London: Springer London, 2010:71–81.10.1007/978-1-84882-120-0_5Search in Google Scholar

[123] Zhang C, Williams MA, Sorensen TK, King IB, Kestin MM, Thompson ML, et al. Maternal plasma ascorbic acid (vitamin C) and risk of gestational diabetes mellitus. Epidemiology 2004;15:597–604.10.1097/01.ede.0000134864.90563.faSearch in Google Scholar PubMed

[124] Yessoufou A, Nekoua MP, Gbankoto A, Mashalla Y, Moutairou K. Beneficial effects of omega-3 polyunsaturated Fatty acids in gestational diabetes: consequences in macrosomia and adulthood obesity. J Diabetes Res 2015;2015:731434.10.1155/2015/731434Search in Google Scholar PubMed PubMed Central

[125] Zhou SJ, Yelland L, McPhee AJ, Quinlivan J, Gibson RA, Makrides M. Fish-oil supplementation in pregnancy does not reduce the risk of gestational diabetes or preeclampsia. Am J Clin Nutr 2012;95:1378–84.10.3945/ajcn.111.033217Search in Google Scholar PubMed

[126] Taylor BL, Woodfall GE, Sheedy KE, O’Riley ML, Rainbow KA, Bramwell EL, et al. Effect of probiotics on metabolic outcomes in pregnant women with gestational diabetes: A systematic review and meta-analysis of randomized controlled trials. Nutrients 2017;9.10.3390/nu9050461Search in Google Scholar PubMed PubMed Central

[127] Luoto R, Laitinen K, Nermes M, Isolauri E. Impact of maternal probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: a double-blind, placebo-controlled study. Br J Nutr 2010;103:1792–9.10.1017/S0007114509993898Search in Google Scholar PubMed

[128] Laganà AS, Vitale SG, Ban Frangež H, Vrtačnik-Bokal E, D’Anna R. Vitamin D in human reproduction: the more, the better? An evidence-based critical appraisal. Eur Rev Med Pharmacol Sci 2017;21:4243–51.Search in Google Scholar

[129] Vitale SG, Caruso S, Rapisarda AM, Cianci S, Cianci A. Isoflavones, calcium, Vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: Result from a prospective, randomized, placebo-controlled, parallel-group study. Prz Menopauzalny 2018;17:32–8.10.5114/pm.2018.73791Search in Google Scholar PubMed PubMed Central

[130] Cianci A, Colacurci N, Paoletti AM, Perino A, Cicinelli E, Maffei S, et al. Soy isoflavones, inulin, calcium, and vitamin D3 in post-menopausal hot flushes: an observational study. Clin Exp Obstet Gynecol 2015;42:743–5.10.12891/ceog2008.2015Search in Google Scholar

[131] Colonese F, La Rosa VL, Laganà AS, Vitale SG, Cortinovis D, Bidoli P. Comment on: “Is there a role for vitamin D in human reproduction?” Horm Mol Biol Clin Investig 2017;29:37–8.Search in Google Scholar

[132] Joergensen JS, Lamont RF, Torloni MR. Vitamin D and gestational diabetes: An update. Curr Opin Clin Nutr Metab Care 2014;17:360–7.10.1097/MCO.0000000000000064Search in Google Scholar PubMed

[133] Asemi Z, Hashemi T, Karamali M, Samimi M, Esmaillzadeh A. Effects of vitamin D supplementation on glucose metabolism, lipid concentrations, inflammation, and oxidative stress in gestational diabetes: a double-blind randomized controlled clinical trial. Am J Clin Nutr 2013;98:1425–32.10.3945/ajcn.113.072785Search in Google Scholar PubMed

[134] Carlomagno G, Nordio M, Chiu TT, Unfer V. Contribution of myo-inositol and melatonin to human reproduction. Eur J Obstet Gynecol Reprod Biol 2011;159:267–72.10.1016/j.ejogrb.2011.07.038Search in Google Scholar PubMed

[135] Vitale SG, Rossetti P, Corrado F, Rapisarda AM, La Vignera S, Condorelli RA, et al. How to achieve high-quality oocytes? The key role of myo-inositol and melatonin. Int J Endocrinol. 2016;2016:4987436–.10.1155/2016/4987436Search in Google Scholar PubMed PubMed Central

[136] Condorelli RA, La Vignera S, Bellanca S, Vicari E, Calogero AE. Myoinositol: does it improve sperm mitochondrial function and sperm motility? Urology 2012;79:1290–5.10.1016/j.urology.2012.03.005Search in Google Scholar PubMed

[137] Condorelli RA, La Vignera S, Mongioì LM, Vitale SG, Laganà AS, Cimino L, et al. Myo-inositol as a male fertility molecule: speed them up! Eur Rev Med Pharmacol Sci 2017;21:30–5.Search in Google Scholar

[138] Gulino FA, Leonardi E, Marilli I, Musmeci G, Vitale SG, Leanza V, et al. Effect of treatment with myo-inositol on semen parameters of patients undergoing an IVF cycle: in vivo study. Gynecol Endocrinol 2016;32:65–8.10.3109/09513590.2015.1080680Search in Google Scholar PubMed

[139] Ciotta L, Stracquadanio M, Pagano I, Carbonaro A, Palumbo M, Gulino F. Effects of myo-inositol supplementation on oocyte’s quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci 2011;15:509–14.Search in Google Scholar

[140] Laganà AS, Rossetti P, Sapia F, Chiofalo B, Buscema M, Valenti G, et al. Evidence-based and patient-oriented inositol treatment in polycystic ovary syndrome: Changing the perspective of the disease. Int J Endocrinol Metab 2017;15:e43695.10.5812/ijem.43695Search in Google Scholar PubMed PubMed Central

[141] Beemster P, Groenen P, Steegers-Theunissen R. Involvement of inositol in reproduction. Nutr Rev 2002;60:80–7.10.1301/00296640260042748Search in Google Scholar PubMed

[142] Laganà AS, Sapia F, La Rosa VL, Vitale SG. Comment on “Inositols: from physiology to rational therapy in gynecological clinical practice”. Expert Opin Drug Metab Toxicol 2016;12:1527.10.1080/17425255.2016.1248598Search in Google Scholar PubMed

[143] Reyes-Muñoz E, Sathyapalan T, Rossetti P, Shah M, Long M, Buscema M, et al. Polycystic ovary syndrome: implication for drug metabolism on assisted reproductive techniques—A literature review. Adv Ther 2018;35:1805–15.10.1007/s12325-018-0810-1Search in Google Scholar PubMed PubMed Central

[144] Büttner J. [Johann Joseph von Scherer (1814–69). The early history of clinical chemistry]. J Clin Chem Clin Biochem 1978;16:478–83.Search in Google Scholar

[145] Baillargeon J-P, Iuorno MJ, Apridonidze T, Nestler JE. Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women With polycystic ovary syndrome. Metab Syndr Relat Disord 2010;8:127–36.10.1089/met.2009.0052Search in Google Scholar PubMed PubMed Central

[146] D’Anna R, Scilipoti A, Giordano D, Caruso C, Cannata ML, Interdonato ML, et al. 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;36:854–7.10.2337/dc12-1371Search in Google Scholar PubMed PubMed Central

[147] Corrado F, D’Anna R, di Vieste G, Giordano D, Pintaudi B, Santamaria A, et al. The effect of myoinositol supplementation on insulin resistance in patients with gestational diabetes. Diabet Med 2011;28:972–5.10.1111/j.1464-5491.2011.03284.xSearch in Google Scholar PubMed

[148] Noventa M, Vitagliano A, Quaranta M, Borgato S, Abdulrahim B, Gizzo S. Preventive and therapeutic role of dietary inositol supplementation in periconceptional period and during pregnancy: a summary of evidences and future applications. Reprod Sci 2016;23:278–88.10.1177/1933719115594018Search in Google Scholar PubMed

[149] Croze ML, Soulage CO. Potential role and therapeutic interests of myo-inositol in metabolic diseases. Biochimie 2013;95:1811–27.10.1016/j.biochi.2013.05.011Search in Google Scholar PubMed

[150] Croze ML, Géloën A, Soulage CO. Abnormalities in myo-inositol metabolism associated with type 2 diabetes in mice fed a high-fat diet: benefits of a dietary myo-inositol supplementation. Br J Nutr 2015;113:1862–75.10.1017/S000711451500121XSearch in Google Scholar PubMed

[151] Di Paolo G, De Camilli P. Phosphoinositides in cell regulation and membrane dynamics. Nature 2006;443:651–7.10.1038/nature05185Search in Google Scholar PubMed

[152] Genazzani AD, Santagni S, Ricchieri F, Campedelli A, Rattighieri E, Chierchia E, et al. Myo-inositol modulates insulin and luteinizing hormone secretion in normal weight patients with polycystic ovary syndrome. J Obstet Gynaecol Res 2014;40:1353–60.10.1111/jog.12319Search in Google Scholar PubMed

[153] Marone R, Cmiljanovic V, Giese B, Wymann MP. Targeting phosphoinositide 3-kinase: moving towards therapy. Biochim Biophys Acta 2008;1784:159–85.10.1016/j.bbapap.2007.10.003Search in Google Scholar PubMed

[154] Saltiel AR, Kahn CR. Insulin signalling and the regulation of glucose and lipid metabolism. Nature 2001;414:799–806.10.1038/414799aSearch in Google Scholar PubMed

[155] Luo J, Field SJ, Lee JY, Engelman JA, Cantley LC. The p85 regulatory subunit of phosphoinositide 3-kinase down-regulates IRS-1 signaling via the formation of a sequestration complex. J Cell Biol 2005;170:455–64.10.1083/jcb.200503088Search in Google Scholar PubMed PubMed Central

[156] Engelman JA. Targeting PI3K signalling in cancer: opportunities, challenges and limitations. Nat Rev Cancer 2009;9:550–62.10.1038/nrc2664Search in Google Scholar PubMed

[157] Cho H, Thorvaldsen JL, Chu Q, Feng F, Birnbaum MJ. Akt1/PKBalpha is required for normal growth but dispensable for maintenance of glucose homeostasis in mice. J Biol Chem 2001;276:38349–52.10.1074/jbc.C100462200Search in Google Scholar PubMed

[158] Cho H, Mu J, Kim JK, Thorvaldsen JL, Chu Q, Crenshaw EB, et al. Insulin resistance and a diabetes mellitus-like syndrome in mice lacking the protein kinase Akt2 (PKB beta). Science 2001;292:1728–31.10.1126/science.292.5522.1728Search in Google Scholar PubMed

[159] Easton RM, Cho H, Roovers K, Shineman DW, Mizrahi M, Forman MS, et al. Role for Akt3/protein kinase Bgamma in attainment of normal brain size. Mol Cell Biol 2005;25:1869–78.10.1128/MCB.25.5.1869-1878.2005Search in Google Scholar PubMed PubMed Central

[160] Zhang C, Qiu C, Hu FB, David RM, van Dam RM, Bralley A, et al. Maternal plasma 25-hydroxyvitamin D concentrations and the risk for gestational diabetes mellitus. PLoS One 2008;3:e3753.10.1371/journal.pone.0003753Search in Google Scholar PubMed PubMed Central

[161] Thong FS, Dugani CB, Klip A. Turning signals on and off: GLUT4 traffic in the insulin-signaling highway. Physiology (Bethesda) 2005;20:271–84.10.1152/physiol.00017.2005Search in Google Scholar PubMed

[162] Barthel A, Schmoll D, Unterman TG. FoxO proteins in insulin action and metabolism. Trends Endocrinol Metab 2005;16:183–9.10.1016/j.tem.2005.03.010Search in Google Scholar PubMed

[163] Facchinetti F, Dante G, Petrella E, Neri I. Dietary interventions, lifestyle changes, and dietary supplements in preventing gestational diabetes mellitus: a literature review. Obstet Gynecol Surv 2014;69:669–80.10.1097/OGX.0000000000000121Search in Google Scholar PubMed

[164] Santamaria A, Alibrandi A, Di Benedetto A, Pintaudi B, Corrado F, Facchinetti F, et al. Clinical and metabolic outcomes in pregnant women at risk for gestational diabetes mellitus supplemented with myo-inositol: a secondary analysis from 3 RCTs. Am J Obstet Gynecol 2018. DOI: 10.1016/j.ajog.2018.05.018.Search in Google Scholar PubMed

[165] Howlett A, Ohlsson A, Plakkal N. Inositol in preterm infants at risk for or having respiratory distress syndrome. Cochrane Database Syst Rev 2019;7:CD000366.10.1002/14651858.CD000366.pub4Search in Google Scholar PubMed PubMed Central

Received: 2019-05-19
Accepted: 2019-07-03
Published Online: 2019-09-17

© 2019 Walter de Gruyter GmbH, Berlin/Boston

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