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 I (2) 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.