1248-P: Association of Oxidative Stress Markers with Incident Hyperglycemia in Gestational Diabetes Mellitus—Impact of a Diabetes Prevention Program

Introduction & Objective: Gestational Diabetes (GDM) poses risk for developing type 2 diabetes (T2D). The role of oxidative stress in GDM and its association with incident diabetes remains unclear. This study aimed to assess the link between oxidative stress markers and incident hyperglycemia in women with and without GDM.

Methods: Prospective cohort. Pregnant women with GDM (n=201) or without GDM (n=50) undergoing cesarean section participated in an 18-month postpartum prevention program. The program emphasized healthy practices, physical activity, and psychosocial support. Oxidative stress markers [malondialdehyde (MDA), reduced glutathione (GSH), antioxidant capacity (DPPH), carbonylated proteins], and adiponectin were measured at the end of pregnancy and at 18 months later. A control group (CG) (n=57) received standard care. Multiple linear regression identified intervention-related differences.

Results: Baseline GDM women exhibited elevated oxidative stress markers and adiponectin compared to non-GDM counterparts. Antioxidant capacity was lower in GDM (40 vs. 67.8%, p=<0.001). Post-intervention, GDM cases showed a greater reduction in MDA and adiponectin (-37.55 vs-34.08 nmol, p=0.021; -751.54 vs-210.31 pg/mL, p<0.001 respectively) and antioxidant capacity increased (in both groups: 1.0 - 0.28%, vs CG -7.23 p=0.009). At follow-up, 6% progressed to T2D, and 37.3% to prediabetes. Basal malondialdehyde concentrations, pregestational BMI, and HbA1c positively correlated with incident hyperglycemia. Conversely, the change in carbonylated proteins concentrations inversely correlated with incident hyperglycemia.

Conclusion: Oxidative markers are associated with T2D risk in GDM. The diabetes prevention program effectively reduced malondialdehyde and adiponectin levels. These findings highlight the role of oxidative stress in GDM prevention strategies.