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肌醇补充治疗妊娠期糖尿病:对血糖控制和母婴结局的影响。

Myoinositol supplementation in the treatment of gestational diabetes mellitus: effects on glycaemic control and maternal-foetal outcomes.

机构信息

Dipartimento di Promozione della Salute, Materno-Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy.

出版信息

BMC Pregnancy Childbirth. 2022 Jun 26;22(1):516. doi: 10.1186/s12884-022-04852-3.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is defined as glucose intolerance with onset during pregnancy. It is characterized by high risk of adverse outcomes for the mother and the foetus, if not adequately controlled. The aim of the study was to evaluate the effects of 4000 mg of myoinositol supplementation in women with GDM on maternal-foetal outcomes, compared to controls.

METHODS

A cohort of 330 women with GDM, 150 supplemented with myoinositol and 180 controls were enrolled. Clinical and metabolic parameters and the prevalence of maternal and foetal complications were assessed.

RESULTS

The same number of women in the two groups started insulin as additional therapy. Women treated with myoinositol more frequently had a long-acting insulin scheme of treatment than those untreated (p<0.001), while women untreated with myoinositol more frequently had a basal-bolus insulin regimen (p<0.001) compared to women on myoinositol. Patients treated with myoinositol had significantly lower fasting plasma glucose (p=0.032), post-prandial dinner glucose (p=0.014), insulin requirement both in the 2nd and in the 3rd trimesters (p=0.001 and p<0.001, respectively), than those not treated with myoinositol. With regard to maternal/foetal outcomes, lower birth weight (p=0.043) and frequency of hypoglycaemic events (p=0.001) were observed in women treated with myoinositol compared to controls.

CONCLUSIONS

Women with GDM treated with myoinositol showed an improved glycaemic control in the 3 trimester of pregnancy and a lower insulin requirement, when insulin was added to the treatment, compared to controls. In addition, they showed lower preterm birth weight and neonatal hypoglycaemia, compared to women not supplemented with myoinositol.

摘要

背景

妊娠糖尿病(GDM)定义为妊娠期间发生的葡萄糖不耐受。如果不能得到充分控制,它会使母亲和胎儿面临高风险的不良结局。本研究的目的是评估在患有 GDM 的女性中补充 4000 毫克肌醇对母婴结局的影响,并与对照组进行比较。

方法

招募了 330 名患有 GDM 的女性,其中 150 名接受肌醇补充,180 名作为对照组。评估了临床和代谢参数以及母婴并发症的发生率。

结果

两组中接受胰岛素治疗的女性数量相同。接受肌醇治疗的女性更频繁地采用长效胰岛素治疗方案,而未接受肌醇治疗的女性更频繁地采用基础-餐时胰岛素方案(p<0.001)。与接受肌醇治疗的女性相比,未接受肌醇治疗的女性需要更多的胰岛素。接受肌醇治疗的女性空腹血糖(p=0.032)、晚餐后血糖(p=0.014)、第二和第三孕期胰岛素需求(p=0.001 和 p<0.001)均显著降低。与对照组相比,接受肌醇治疗的女性新生儿体重(p=0.043)和低血糖事件发生率(p=0.001)更低。

结论

与对照组相比,接受肌醇治疗的 GDM 女性在妊娠晚期的血糖控制得到改善,当添加胰岛素治疗时,胰岛素需求也降低。此外,与未接受肌醇补充的女性相比,她们的早产儿体重和新生儿低血糖发生率也较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cec/9233779/67d1e14ea050/12884_2022_4852_Fig1_HTML.jpg

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