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Abstract Gestational diabetes (GDM) is defined as any abnormal carbohydrate intolerance resulting in hyperglycemia of variable severity with onset or first recognition during pregnancy. In diabetes mellitus the persistent hyperglycemia causes increase in production of free radicals especially reactive oxygen species (ROS) from glucose autoxidation and protein glycosylation. The excessive production of ROS is a major cause of unfavorable evolution of diabetes such as target organ damage like kidney, heart and smooth muscle. Considering the role of oxidative stress for the development of structural and functional cell damage and the progression of DM, many scientific efforts are directed towards search and application of effective antioxidants. The present study was designed to investigate the effect of L- Carnitine, as antioxidants on plasma glucose and insulin level, uterine oxidative stress, uterine contractility, connexin 43 and caspase 3 expressions in diabetic pregnant rat model. The study involved 40 female Sprague Dawley rats which were subdivided into five groups; G I (NC), G II (DI): in which rats received single i.p injection of 40 mg/kg b.wt STZ at day 1 of pregnancy, G III (DI+CAR): in which rats received STZ as above, and then at day 3 of pregnancy, diabetic pregnant rats received daily i.p L ̵ carnitine injection at a dose of 100 mg/kg b.wt till end of pregnancy, G IV (DI+INS): in which rats received STZ as above, and then at day 3 of pregnancy, diabetic pregnant rats received daily i.p insulin injection at a dose of 1 IU/100 g b.wt (till end of pregnancy, and G V (DI+Com): in which rats received STZ as above, and then at day 3 of pregnancy, diabetic pregnant rats received insulin and L ̵ carnitine at the same doses mentioned before. Plasma glucose and insulin level, oxidative stress markers, uterine contractility, pathological changes and expression of connexin 43 and capase 3 were assessed at the end of the experiment and scarifying of rats. The present study revealed that: 1. STZ induced DM caused impaired uterine contractility which may be caused by hyperglycemia, increased oxidative stress, down regulation of gap junction proteins as evidenced by reduced expression of connexin 43, and increased apoptosis evidenced by increased expression of caspase 3 in diabetic group compared to normal control group. 2. Treatment with L ̵ carnitine caused mild improvement while treatment with insulin caused marked improvement in the studied parameters. 3. A combination of L ̵ carnitine and insulin offered more powerful effect than each agent did alone against GDM in rats. 4. The beneficial effect of L ̵ carnitine could be attributed to the antioxidant, anti-apoptotic, anti-inflammatory properties of it as well as upregulation of connexin 43. In conclusion it is recommended to use l carnitine as an adjuvant ttt with diabetes. |