D-chiro-inositol--its functional role in insulin action and its deficit in insulin resistance

Int J Exp Diabetes Res. 2002;3(1):47-60. doi: 10.1080/15604280212528.


In this review we discuss the biological significance of D-chiro-inositol, originally discovered as a component of a putative mediator of intracellular insulin action, where as a putative mediator, it accelerates the dephosphorylation of glycogen synthase and pyruvate dehydrogenase, rate limiting enzymes of non-oxidative and oxidative glucose disposal. Early studies demonstrated a linear relationship between its decreased urinary excretion and the degree of insulin resistance present. When tissue contents, including muscle, of type 2 diabetic subjects were assayed, they demonstrated a more general body deficiency. Administration of D-chiro-inositol to diabetic rats, Rhesus monkeys and now to humans accelerated glucose disposal and sensitized insulin action. A defect in vivo in the epimerization of myo-inositol to chiro-inositol in insulin sensitive tissues of the GK type 2 diabetic rat has been elucidated. Thus, administered D-chiro-inositol may act to bypass a defective normal epimerization of myo-inositol to D-chiro-inositol associated with insulin resistance and act to at least partially restore insulin sensitivity and glucose disposal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Glucose / physiology*
  • Diabetes Mellitus, Type 1 / physiopathology*
  • Glycogen Synthase / metabolism
  • Inositol / chemistry
  • Inositol / deficiency*
  • Inositol / physiology*
  • Insulin / physiology*
  • Insulin Resistance / physiology*
  • Kinetics
  • Macaca mulatta
  • Obesity / physiopathology
  • Rats
  • Stereoisomerism


  • Blood Glucose
  • Insulin
  • Inositol
  • Glycogen Synthase