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Diabetes
Chapter 26. Antioxidants, Oxidative Stress and Preeclampsia in Type 1 Diabetes
Alecia L. Bryant , Arpita Basu , Timothy J. Lyons
The prevalence of preeclampsia (PE), a pregnancy-specific hypertensive disorder, is significantly higher in women with type 1 diabetes mellitus (T1DM) than in non-diabetic women. Observational studies, mostly cross-sectional in non-diabetic women, have associated higher levels of oxidative stress and lower antioxidant enzymes and vitamins in PE cases versus controls. The prospective study reported by our group is the first to correlate Ξ±- and Ξ²-carotene deficiencies in pregnant T1DM women with subsequent development of PE. Among antioxidant nutrients of interest in PE, vitamins C and E have been most extensively studied in experimental models and clinical trials. The largest clinical trial on vitamins C and E supplementation in women with T1DM revealed no overall reduction in risk for PE, but a significant reduction was found in the subgroup of women with low baseline levels of these vitamins. Emerging research shows potential effects for l-arginine, a combination of B vitamins and trace minerals, and vitamin D in reducing risk for PE, although their effects in pregnancies complicated by diabetes remain to be clarified.
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