||Uncertainties identified in research recommendations
||Cochrane Pregnancy and Childbirth Group
|Why is there uncertainty?
||Reliable up-to-date systematic reviews have revealed important continuing uncertainties about treatment effects
Implications for Research Although the currently available evidence indicates that antenatal supplementation with myo-inositol may be beneficial in reducing the incidence of GDM, the effect on important neonatal outcomes is unclear. Further well-designed randomised controlled trials are required, and should be sufficiently powered to detect differences in relevant maternal and neonatal outcomes. They should include participants of varying ethnicities and with various risk factors for GDM, such as obesity, polycystic ovarian syndrome, family history, and previous GDM, and explore the optimal dose, frequency and timing of supplementation. It is important that trials report on potential harms including adverse effects. In view of the availability of myo-inositol as a dietary supplement and its relatively low cost compared with traditional interventions for preventing GDM, future randomised controlled trials should include an economic analysis, or at least report on health service use and costs. If the efficacy of antenatal supplementation with myo-inositol compared with placebo is established, then it will also be useful to conduct trials that compare the use of myo-inositol with other preventative interventions such as lifestyle (diet and exercise) or pharmacological interventions such as metformin.
References to reliable up-to-date systematic reviews:
Crawford TJ, Crowther CA, Alsweiler J, Brown J. Antenatal dietary supplementation with myo-inositol in women during pregnancy for preventing gestational diabetes. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD011507. DOI: 10.1002/14651858.CD011507.pub2
|What is needed?
|Systematic reviews that need updating or extending
|Systematic reviews in preparation
|Ongoing controlled trials
||A randomised controlled trial to investigate the role of the food supplement inositol in the general health of those at risk of developing gestational diabetes mellitus
|Which health conditions?
||Nutritional metabolic and endocrine disorders | Diabetes | Gestational diabetes
|What is person's age?
|Which types of treatments?
||Diet | Drug
Incidence of gestational diabetes: change in symptoms, or change in management of symptoms (glucose intolerance, incidence of hypertensive disorders of pregnancy, neonatal outcomes (large-for-gestational age, perinatal mortality, mortality or morbidity composite), incidence of caesarean section, incience of macrosomia, neonatal hypoglycaemia, shoulder dystocia, long-term childhood or adulthood outcomes); adverse effects or complications; patient satisfaction; health related quality of life; service related issues; and health related cost
||Publication date:10 Mar 2016
|Last reviewed date:10 Mar 2017
||Publication Type:Known Uncertainty
|The DUETs team endeavours to ensure that information is correct at the time of data entry