1.The efficacy and safety of myo-inositol supplementation for the prevention of gestational diabetes mellitus in overweight and obese pregnant women: A systematic review and meta-analysis
Patricia Ann Factor ; Hannah Corpuz
Journal of the ASEAN Federation of Endocrine Societies 2023;38(2):102-112
Background:
Myo-inositol has emerged as one of the preventive therapies for the development of gestational diabetes mellitus in at-risk populations. This systematic review and meta-analysis was conducted to determine the efficacy and safety of myo-inositol in decreasing the incidence of gestational diabetes in overweight and obese pregnant women.
Methodology:
This meta-analysis was conducted using the standard Cochrane methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. Inclusion criteria were randomized controlled trials (RCTs) that enrolled overweight and obese pregnant women and used myo-inositol supplementation. The primary outcome was the incidence of gestational diabetes mellitus at 24-28 weeks. Secondary outcomes included cesarean section rate, the incidence of pregnancy-induced hypertension, macrosomia and preterm delivery. Risk ratios (RRs) and 95% confidence intervals (CIs) were used for dichotomous data.
Results:
Six RCTs were included. Compared to standard micronutrient supplementation, standard dose of myo-inositol (4 g) may reduce the incidence of GDM (RR 0.54; CI [0.30, 0.96]; n = 887 women), but the certainty of evidence is low to very low. With low-dose myo-inositol however, evidence is uncertain about its benefit on the incidence of gestational diabetes mellitus in overweight and obese women with RR 0.71; CI [0.14, 3.50]. No adverse effects were noted. For the secondary outcomes, standard dose myo-inositol appears to reduce the incidence of pregnancy-induced hypertension and preterm delivery, but the certainty of evidence is low to very low.
Conclusion
Current evidence is uncertain on the potential benefit of myo-inositol supplementation in overweight and obese pregnant women. While studies show that 4 g myo-inositol per day may decrease the incidence of GDM, pregnancy-induced hypertension and pre-term birth with no associated risk of serious adverse events, the certainty of evidence is low to very low. Future high-quality trials may provide more compelling evidence to support practice recommendations.
Diabetes, Gestational
;
Obesity
;
Inositol Phosphates
2.Reliability and validity of the Filipino-translated diabetes self-management questionnaire and its correlation with HbA1c
Hannah U. Corpuz, MD ; Marie Angeline O. Ganiban, MD ; Alexis N. Aguinaldo, RN, MAN
Philippine Journal of Internal Medicine 2023;61(2):57-64
Background:
Diabetes self-management is a fundamental aspect of diabetes care and has a significant impact on diabetes-
related mortality and morbidity. Assessment of self-care management is thus essential for clinicians and educators seeking
better outcomes. However, there are no Filipino-validated tools to objectively measure this.
Methodology:
A cross-sectional analytic study was done among adult Type 2 diabetic mellitus (T2DM) patients at the Ilocos
Training and Regional Medical Center (ITRMC) Department of Internal Medicine outpatient clinic and three private diabetes
clinics to determine the reliability and validity of the Filipino-translated Diabetes Self-Management Questionnaire (DSMQ)
and its association with glycemic control as measured using glycosylated hemoglobin (HbA1c) values and categorized into
good (< 7%), moderate (7-8.9%) and poor (> 9%) control. The English version of the DSMQ was translated to Filipino using
forward-backward translation. The pre-tested Filipino translated questionnaire was then distributed to the participants and
the responses were analyzed using Cronbach’s alpha, Pearson’s coefficient, and one–way analyses of variance.
Results:
There were a total of 78 respondents. The test-retest reliability showed a statistically significant correlation
(p < 0.05). All the items showed a high difficulty index. Known group validity was computed based on categorized HbA1c
values. DSMQ sum scores and subscales showed no significant differences among the three categories of glycemic control.
Conclusion
The Filipino-translated DSMQ is a reliable tool for measuring the self-care of Filipinos with type 2 diabetes
mellitus. Future research using it with a larger sample size and analysis for other factors affecting diabetes control may be
better able to demonstrate its association with glycemic control.
self-management