A pilot study of D-chiro-inositol plus folic acid in overweight patients with type 1 diabetes

Acta Diabetol. 2017 Apr;54(4):361-365. doi: 10.1007/s00592-016-0954-x. Epub 2016 Dec 30.


Aims: To improve insulin sensitivity, insulin-sensitizing drugs such as metformin are commonly used in overweight and obese T1D patients. Similarly to metformin, D-chiro-inositol (DCI), as putative mediator of intracellular insulin action, can act as insulin sensitizer. The aim of this pilot study was to evaluate the hypothesis that DCI plus folic acid may improve glucose control reducing insulin resistance in overweight or obese T1D patients.

Methods: A 24-week randomized control trial was carried out in 26 overweight or obese T1D patients, undergoing intensive insulin therapy. Patients were randomized to 1 g DCI plus 400 mcg folic acid once daily (treated group) or to 400 mcg folic acid only once daily (control group). The primary end point was to evaluate the efficacy of DCI on metabolic control as assessed by HbA1c. As secondary endpoints, BMI and insulin requirement (IR) were evaluated. Paired t test (two tailed) and analysis of variance were used to evaluate differences in HbA1c, BMI and IR at different time points.

Results: A significant reduction in HbA1c levels in treated group versus control group (7.5% ± 0.9 vs. 7.9% ± 1.7, respectively, p < 0.05) was observed. However, no significant reduction in BMI and IR was observed [(BMI 25.7 ± 2.8 vs. 26.7 ± 1.0, respectively, p NS); (IR 0.52 ± 0.26 vs. 0.52 ± 0.19, respectively, p NS)].

Conclusions: This trial demonstrated for the first time that DCI plus folic acid oral supplementation can improve metabolic control in overweight T1D patients. CLINICALTRIAL.

Gov id: NCT02730949.

Keywords: D-chiro-Inositol (DCI); Folic acid; Glycaemic control; Insulin resistance; Insulin therapy; Type 1 diabetes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / metabolism
  • Female
  • Folic Acid / administration & dosage*
  • Humans
  • Inositol / administration & dosage*
  • Insulin / metabolism
  • Insulin Resistance
  • Male
  • Metformin / therapeutic use
  • Middle Aged
  • Overweight / complications
  • Overweight / drug therapy*
  • Overweight / metabolism
  • Pilot Projects
  • Young Adult


  • Blood Glucose
  • Insulin
  • Inositol
  • Metformin
  • Folic Acid

Associated data

  • ClinicalTrials.gov/NCT02730949
  • ClinicalTrials.gov/NCT02730949