Department of Medicine and Aging Sciences and Centro Scienze dell'Invecchiamento-Medicina Traslazionale (CeSI-MeT), University G. D'Annunzio, Chieti, Italy.
Diabetes Metab Res Rev. 2019 Jul;35(5):e3154. doi: 10.1002/dmrr.3154. Epub 2019 Apr 10.
Pregnancies complicated by diabetes have largely increased in number over the last 50 years. Pregnancy is characterized by a physiologic increase in insulin resistance, which, associated with increased oxidative stress and inflammations, could induce alterations of glucose metabolism and diabetes. If not optimally controlled, these conditions have a negative impact on maternal and foetal outcomes. To date, one can resort only to diet and lifestyle to treat obesity and insulin resistance during pregnancy, and insulin remains the only therapeutic option to manage diabetes during pregnancy. However, in the last years, in a variety of experimental models, inositol and antioxidants supplementation have shown insulin-sensitizing, anti-inflammatory, and antioxidant properties, which could be mediated by some possible complementary mechanism of action. Different isomers and multiple combinations of these compounds are presently available: Aim of the present review article is to examine the existing evidence in order to clarify and/or define the effects of different inositol- and antioxidant-based supplements during pregnancy complicated by insulin resistance and/or by diabetes. This could help the clinician's evaluation and choice of the appropriate supplementation regimen.
在过去的 50 年中,受糖尿病影响的妊娠数量大大增加。妊娠的特点是胰岛素抵抗的生理性增加,这种增加与氧化应激和炎症的增加相结合,可能导致葡萄糖代谢和糖尿病的改变。如果不能得到最佳控制,这些情况会对母婴结局产生负面影响。迄今为止,人们只能通过饮食和生活方式来治疗肥胖和妊娠期间的胰岛素抵抗,而胰岛素仍然是治疗妊娠期间糖尿病的唯一治疗选择。然而,在过去的几年中,在各种实验模型中,肌醇和抗氧化剂的补充显示出了胰岛素增敏、抗炎和抗氧化的特性,这些特性可能是通过一些可能的互补作用机制介导的。这些化合物的不同异构体和多种组合目前都有:本文的目的是检查现有的证据,以阐明和/或定义在胰岛素抵抗和/或糖尿病合并妊娠时,不同肌醇和抗氧化剂补充剂的作用。这可以帮助临床医生评估和选择适当的补充方案。