Efficacy of inositol supplementation in the prevention and treatment of gestational diabetes mellitus: A meta-analysis

doi:10.4239/wjd.v16.i9.107871

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World Journal of Diabetes

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Meta-Analysis

World J Diabetes. Sep 15, 2025; 16(9): 107871
Published online Sep 15, 2025. doi: 10.4239/wjd.v16.i9.107871

Efficacy of inositol supplementation in the prevention and treatment of gestational diabetes mellitus: A meta-analysis

Ru-Tong Wang, Ying-Qi Feng, Meng-Yao Wang, Yan-Hong Wei, Yu-Jun Huang, Yu-Jia Guo, Xuan Liu, Xiao-Can Lei, Kong-Wei Huang, Hua Huang

Ru-Tong Wang, Ying-Qi Feng, Meng-Yao Wang, Yan-Hong Wei, Yu-Jun Huang, Yu-Jia Guo, Xuan Liu, Xiao-Can Lei, Kong-Wei Huang, Clinical Anatomy & Reproductive Medicine Application Institute, Hengyang Medical School, University of South China, Hengyang 421001, Hunan Province, China

Yan-Hong Wei, Hua Huang, Department of Embryology Laboratory, Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning 530000, Guangxi Zhuang Autonomous Region, China

Co-first authors: Ru-Tong Wang and Ying-Qi Feng.

Co-corresponding authors: Kong-Wei Huang and Hua Huang.

Author contributions: Wang RT, Feng YQ, Wang MY, Wei YH, Huang YJ, Guo YJ, Liu X, and Lei XC wrote the original draft; Wang RT and Feng YQ contributed to data curation, resources, and formal analysis; Wang RT, Feng YQ, Wang MY, Wei YH, Huang YJ, Guo YJ, Liu X, and Lei XC contributed to investigation; Wang RT, Feng YQ, Wei YH, Huang YJ, and Lei XC contributed to data organization; Wang RT, Feng YQ, Huang KW, and Huang H contributed to the conceptualization; Huang KW and Huang H contributed to methodology, project administration, supervision and writing - review & editing. Wang RT and Feng YQ contributed equally to this meta-analysis and share co-first authorship. Wang RT was responsible for the literature search, data extraction, and initial draft writing. Feng YQ conducted the data analysis, quality assessment, and manuscript revision. Huang KW and Huang H are co-corresponding authors. Huang KW managed project administration and methodology. Both approved the final version. Huang H provided clinical guidance and reviewed the manuscript. Their combined efforts were essential to the completion of this study. All authors have read and approved the final manuscript.

Supported by the Natural Science Foundation of Guangxi in China, No. 2024GXNSFAA010444, Doctoral Scientific Research Start-up Foundation of University of South China, No. 5525QD005, and Hunan Province Innovation and Entrepreneurship Training Program for College Students, No. S202410555233.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Hua Huang, Department of Embryology Laboratory, Reproductive Hospital of Guangxi Zhuang Autonomous Region, No. 3 Longyuan Road, Qingxiu District, Nanning 530000, Guangxi Zhuang Autonomous Region, China. hh86168263@163.com

Received: March 30, 2025
Revised: July 13, 2025
Accepted: August 20, 2025
Published online: September 15, 2025
Processing time: 165 Days and 17.1 Hours

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) poses a substantial health risk during pregnancy. However, the role of myo-inositol (MI) in GDM prevention and management remains controversial due to conflicting evidence and methodological limitations in previous studies.

AIM

To assess the efficacy of MI in preventing and treating GDM, providing evidence-based guidance for clinical practice.

METHODS

A systematic review was conducted on studies published on the PubMed, Web of Science, and Embase databases from their inception date to July 2024. Twelve studies encompassing 9018 patients were included in the meta-analysis using fixed-effect and random-effects models. Heterogeneity was quantified with I² statistics and the Cochrane Q test, and study quality was appraised using the A Measurement Tool to Assess Systematic Reviews 2 checklist.

RESULTS

MI significantly reduced GDM incidence [relative risk (RR): 0.37; 95% confidence interval (CI): 0.32-0.42], fasting blood glucose [standard mean differences (SMD): -1.31 mg/dL; 95%CI: -1.83 to -0.79], and improved glucose tolerance test outcomes at 1-hour (SMD: -2.63 mg/dL; 95%CI: -3.87 to -1.40) and 2-hour (SMD: -0.95 mg/dL; 95%CI: -1.56 to -0.34). It also decreased the risk of preterm birth (RR: 0.37; 95%CI: 0.28-0.47) and pregnancy-induced hypertension (RR: 0.34; 95%CI: 0.25-0.47). A non-significant trend towards reduced cesarean section rates was observed (RR: 0.82; 95%CI: 0.71-0.94). MI reduced birth weight (SMD: -0.25 kg; 95%CI: -0.32 to -0.17), but had no effect on neonatal hypoglycemia (RR: 0.30; 95%CI: 0.08-1.21) or gestational age at birth (SMD: -0.13 weeks; 95%CI: -0.04 to 0.29).

CONCLUSION

MI demonstrates therapeutic potential in GDM prevention and management, supporting its potential use as a preventive supplement in early pregnancy for high-risk women. Nonetheless, its therapeutic effects in women diagnosed with GDM require further validation.

Keywords: Myo-inositol; D-chiro inositol; Gestational diabetes mellitus; Pregnancy outcomes; Meta-analysis

Core Tip: This meta-analysis reviews evidence on using inositol supplements to prevent and treat gestational diabetes mellitus (GDM). Findings show it significantly lowers GDM rates, fasting blood sugar, and the risk of bad pregnancy outcomes. This suggests inositol is a safe and effective option. Specifically, myo-inositol supplements reduced new GDM cases by 63% and improved glucose tolerance test results. They also decreased chances of preterm birth and pregnancy-induced high blood pressure. While inositol works well for prevention in high-risk women, we need more trials to confirm its treatment benefits for existing GDM. Therefore, clinicians can consider inositol as a preventive measure early in pregnancy for women with risk factors.