Emilio Giugliano, Elisa Cagnazzo, Brunella Giugliano, Donatella Caserta, Massimo Moscarini and Roberto Marci
The negative impact of the gestational diabetes on the maternal and fetal health is well known and this impact is closely related to gestational age at which the diagnosis is done. Therefore, the use of therapeutic options able to prevent or delay the gestational diabetes occurrence has a positive impact on maternal and neonatal outcomes.
Physical activity and dietary advice represent the first choice and they are the most studied as well. They represent a non-pharmacological option and have a positive impact on insulin resistance although they do not seem to prevent the gestational diabetes onset.The preconceptional use of metformin in women with polycystic ovary syndrome protects the pancreatic beta cell reserve preventing or delaying the occurrence of gestational diabetes. However, there are also doubts on the drug safety in pregnancy since it completely crosses the placenta.From this point of view, the inositol could represent an excellent alternative.Its role as insulin sensitizing agent is well documented on improving both the hormonal and reproductive parameters. However, the studies on its preconceptional use in preventing gestational diabetes are too limited though the first results are extremely encouraging.