Gestational Diabetes, Inositol and PCOS

by Amy Medling, founder of PCOS Diva

There are a lot of rumors and misconceptions about PCOS and risks in pregnancy. For more about these perceived risks, read, “Good News & Bad News: Pregnancy Complications in PCOS.” One of the most common concerns among pregnant women, whether they have PCOS or not, is gestational diabetes. This potentially serious condition does effect women with PCOS, but is our risk really higher?

Gestational Diabetes and PCOS

Gestational Diabetes (GD) is a period of increased blood sugar levels that happens during pregnancy and normally stabilizes after giving birth. This disease can happen at any stage of pregnancy, but is more common during the second half. GD happens when your body is unable to produce enough insulin to meet the extra needs during pregnancy.

Women with PCOS already suffer from insulin resistance and are often already categorized under prediabetes which all the more makes screening for GD a must. Not only for the mother, GD can also cause problems for the baby during and after birth, but the risk of this disease can be mitigated if it is detected and managed as early as possible.

Risk Factors

This 2014 cross-sectional study in Iran focused on 234 spontaneous pregnant women without PCOS, 234 pregnant women with PCOS and 234 pregnant non-PCOS women in identifying risk factors regarding GD. Results show the following increases likelihood of GD:

BMI of 30 and above;
Previously diagnosed with GD;
If the patient is 35 years old and above;
History of infertility;
Family history of diabetes; and
History of PCOS

The study goes on to indicate 54.9% of the incidence of GD was found among pregnant women with PCOS.

Symptoms

Unfortunately, GD doesn’t usually cause any symptoms and is often only revealed through screening. However, GD is similar t

o Type 2 Diabetes in such a way that they may share similar symptoms such as:

Increased thirst;
Increases frequency of urinating;
Dry mouth; and
Lethargy or unexplained fatigue

These symptoms may or may not relate to GD, however, since they are common during pregnancy anyway and aren’t usually signs of any disease or health problems.

What Happens When You Get Gestational Diabetes?

Most of the time, women who get GD have normal healthy pregnancies with healthy babies. There are certain problems that may arise if the mother’s body doesn’t respond well to GD such as:

A larger than usual baby which can lead to difficulty in delivery, induced labor, and a C-section
Polyhydramnios or too much amniotic fluid which results to premature labor and issues with delivery
Premature birth that often happens before the 37th week of pregnancy
Pre-eclampsia, a condition that elevates blood pressure during pregnancy and can lead to pregnancy problems if not treated
The baby acquiring low blood sugar, yellowing of skin and eyes after birth.
Still birth (though rare)

Acquiring GD also increases your risk for developing Type 2 Diabetes specially if you have PCOS.

Screening for Gestational Diabetes

Prevention is the best cure in any form of disease and GD is no different. The best way to detect GD is if expecting mothers participate in screening. The screening test used for GD is called oral glucose tolerance test (OGTT) and usually takes about two hours.

OGTT involves having a fasting blood test in the morning. You are then provided a very sweet fluid called glucose drink. After two hours, the attending staff will again extract blood from you to check how your body responds to glucose.

The OGTT is performed when a woman is between 24-28 weeks pregnant. If you’re someone who experienced GD before, you’ll be offered the test earlier in pregnancy and once again by 24-28 weeks if the first test comes out normal.

Possible Treatments

Let’s say you already have GD. Is there anything you can do? The usual prescriptions involve you personally monitoring blood sugar levels by means of a blood sugar test kit and making lifestyle changes. The blood sugar test kit is there to make sure you know exactly what your current blood sugar is for the day, especially if it’s too high or within normal range. Lifestyle changes involve dietary adjustments as well as exercise to also make sure the blood sugar levels in your body are controlled.

In addition, you may use a myo-inositol supplement such as Ovasitol. The science behind myo-inositol is sound as plenty of research suggests its efficacy when it comes to lowering insulin resistance and potentially preventing the occurrence of GD.

Myo-Inositol and Gestational Diabetes

A 2015 studyconducted in China was done to determine whether a myo-inositol supplement will increase the action of endogenous insulin, which is mainly measured by markers of insulin resistance. A total of 5 trials containing 513 participants were included. The experiment resulted to a significant reduction in aspects of gestational diabetes incidence, fasting glucose OGTT, and related complications.
An earlier studyutilized myo-Inositol supplementation on pregnant women with a family history of Type 2 Diabetes. The experiment was a 2-year, prospective, randomized, open-label, and placebo-controlled study and was carried out 220 pregnant caucasian women. The results show myo-inositol supplementation actually prevents GD occurrence in women with a family history of Type 2 Diabetes.
A similar study was conducted in 2015with 202 obese women who had a prepregnancy BMI of 30 or greater. The GD rate was significantly reduced in the myo-inositol group compared with the control group, 14.0% compared with 33.6%, respectively.
For PCOS women, the benefits of Myo-Inositol seem to be no different than with women who are pregnant and don’t have PCOS. A total of 46 women were tested with myo-inositol and 37 were the control. The results showed prevalence of GD in the myo-inositol group was only 17.4%versus 54% in the control group.

L-Carnitine

Another possible supplement that could help reduce the risks of GD is L-Carnitine. At least one study noted that 2g Carnitine supplementation can reduce the risk of gestational diabetes by preventing an increase in plasma FFA, which is seen as the main cause of gestational diabetes and insulin resistance.

As much as we like to promote L-Carnitine, we couldn’t find more than one study to fully recommend it for GD. For now, it would be wiser to use myo-inositol as a standalone supplement and not attempt to increase the effects by also taking L-Carnitine on the side. It may create complications for your pregnancy and could lead to unwanted circumstances.

Takeaway

Gestational Diabetes is a normal occurrence in pregnant women, but just because it happens normally doesn’t mean you just have to let it happen to you. There are many risks associated with this disease which can cause complications in your pregnancy. Preventing the onset of gestational diabetes by early screening, monitoring and controlling blood sugar levels, and making diet and lifestyle changes are the best ways to prevent it from happening to you and your soon-to-be newborn child.

Women with PCOS should consider myo-inositol supplements to help reduce insulin resistance and therefore further prevent the onset of gestational diabetes. Before you take anything, get the approval of your physician first to see if your body and baby will respond well to Ovasitol or any other supplements.

As a certified health coach, Amy Medling often hears from women with Polycystic Ovarian Syndrome (PCOS) who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill and live with their symptoms. In response, she founded PCOS Diva and developed a proven protocol of supplements, diet and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health and happiness.

References

Ashrafi M, Sheikhan F, Arabipoor A, Hosseini R, Nourbakhsh F, Zolfaghari Z. Gestational diabetes mellitus risk factors in women with polycystic ovary syndrome (PCOS). Eur J Obstet Gynecol Reprod Biol. 2014; 181:195-9.
Zheng X, Liu Z, Zhang Y, et al. Relationship Between Myo-Inositol Supplementary and Gestational Diabetes Mellitus: A Meta-Analysis. Medicine (Baltimore). 2015;94(42): e1604.
D’anna R, Scilipoti A, Giordano D, et al. myo-Inositol supplementation and onset of gestational diabetes mellitus in pregnant women with a family history of type 2 diabetes: a prospective, randomized, placebo-controlled study. Diabetes Care. 2013;36(4):854-7.
Dʼanna R, Di benedetto A, Scilipoti A, et al. Myo-inositol Supplementation for Prevention of Gestational Diabetes in Obese Pregnant Women: A Randomized Controlled Trial. Obstet Gynecol. 2015;126(2):310-5.
D’anna R, Di benedetto V, Rizzo P, et al. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol. 2012;28(6):440-2.