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Gestational diabetes diet

Gestational diabetes diet 

Making changes to follow a good gestational diabetes diet means achieving lower blood sugar levels, ultimately benefiting your baby hugely and reducing the risks and complications associated with gestational diabetes. But with so much varied information and advice​1–5​, what is a good gestational diabetes diet?

woman looking into an open fridge deciding what to eat

Here I will share the diet I found to work the best for me during my GD pregnancies after the outdated advice I was given did not work. Following extensive research, alongside lived experience of high insulin resistance in gestational diabetes, I created Gestational Diabetes UK and the 8 Golden Rules.

This diet is now shared in many NHS diabetes antenatal clinics nationwide. It has helped over 30,000 mothers with gestational diabetes in the UK and Ireland since I launched my Facebook support group in 2014.

Cut out added sugar

An obvious start to a good gestational diabetes diet is eliminating added sugar. When you have gestational diabetes, the body can no longer process sugar as it used to, so it is important to stop adding sugar into or onto anything. Avoid adding sugar to drinks or food. Cutting back the sugar in a cup of tea or coffee is insufficient.

It’s not as simple as cutting out sugar alone

Unfortunately, sugar is not just found in sugary and sweet things, so cutting out sugar, sweets, and cakes is insufficient to reduce and stabilise blood sugar levels.

Sugar hides in many foods and drinks and comes in many different forms. 

Gestational diabetes = carbohydrate intolerance

The next step to working on a good gestational diabetes diet is looking at carbs [carbohydrates]​6​. Gestational diabetes is defined as carbohydrate intolerance. So this is where we focus on the next step after cutting out the added sugars.

Carbs become sugar in the bloodstream, becoming as problematic as sugar itself. However, there are different types of carbs, and they are processed at different rates, meaning it is important to select the right kinds of carbs. We will look at this in more detail later.

Simplifying the gestational diabetes diet

Getting to grips with a good gestational diabetes diet can be overwhelming and confusing. Therefore to break the dietary advice down more simply, I have created eight golden rules to follow:

Gestational Diabetes UK 8 Golden Rules

list of the GD UK 8 Golden Rules for a gestational diabetes diet

#1. Eat little and often

Avoiding eating is something that many mothers do when they are first diagnosed with gestational diabetes, as they are unsure or too scared about what to eat.  This can actually have a detrimental effect on blood sugar levels.  

32-36 weeks the hardest time

Ideally, we want blood sugar levels that look (if we were to draw a picture) like rolling hills rather than huge spikes and crashes.  The best way to achieve good control over levels is to choose sensible foods and to eat small amounts often.

Aim for three meals and three snacks a day.

If a meal or snack is missed, then blood sugar levels can drop low, and when this happens, the liver dumps stored glucose into the bloodstream.

The glucose raises blood sugar levels, and when eating the next meal, as levels are higher than they should be, they rise even higher.  Following a big spike in levels, the body will signal the pancreas to produce insulin. However, with gestational diabetes, we may not be able to produce enough insulin, or hormones block the body from using the insulin we have produced. Sometimes the body will overproduce insulin and cause a big crash in levels, which starts a rollercoaster of blood sugar levels.

blood sugar levels

#2. Pair Foods – ‘GD Food Pairing’

Macronutrients (macros) are the body’s main nutritional food groups needed to function. These are carbohydrates, proteins and fats.

The three macronutrients have different impacts on blood sugar levels:

Macronutrients impact on blood glucose

Carbohydrates have the fastest and highest impact on blood sugar levels, with 90-100% of carbs turning into glucose (sugar).

To help slow down the release of these sugars into the bloodstream, adding protein and good natural fats to the carbs helps stop the fast excessive peak in blood glucose. This is because the presence of fat will slow the gastric emptying rate​​7,8​, and protein helps reduce postprandial [post-meal] spikes in levels too​​​9–12​. This will mean you can eat carbs more safely without spiking blood sugar levels​13​.

#NeverEatANakedCarb

Do I have to eat paired foods at exactly the same time?

No. In fact, research suggests that if you eat macronutrients in a set order can help to reduce the postprandial glucose response​14​.

#3. High protein

50% of protein turns to glucose in 2 – 4 hours, so protein is a ‘safe food’ on a gestational diabetes diet. Use protein for food pairing to help tolerate carbs better and slow down the absorption of sugar into the bloodstream​9,10​.

Good protein sources are meat, poultry, game, fish, eggs, tofu, Quorn, nuts, yoghurt, hummus, cheese, seeds, quinoa, lentils, chickpeas, beans, and soy milk.

protein rich foods

#4. High Natural Fats

Fat, I hear you cry?! Yes fat! But good, natural fats such as monounsaturated and polyunsaturated fats which include omega-3 and omega-6 fatty acids.

These fats improve blood cholesterol levels and decrease your heart disease risk​15,16​.  They also play an important role in developing your growing baby’s brain, eyes and nervous system and are essential for its growth.

Use the good fats listed below to help with food pairing
MONOUNSATURATED FATS     POLYUNSATURATED FATS  
Avocados Chia, flax, sunflower, sesame, and pumpkin seeds
Canola oil Flaxseed oil
Nuts (almonds, peanuts, macadamia nuts, hazelnuts, pecans, cashews) *Oily fish (salmon, tuna, mackerel, herring, trout, sardines, pilchards)
Olives Pine nuts
Olive oil Rapeseed oil
Peanut butter Soybeans
Peanut oil Soy milk
Sesame oil Tofu
Sunflower oil Walnuts

*PLEASE NOTE oily fish recommendations in pregnancy

table image: Nutrition during pregnancy, British Nutrition Foundation [date accessed April 2023]
food rich in healthy fats

Taking things one step further, full-fat dairy products and animal fats, which are saturated fats, go a long way to helping a good gestational diabetes diet too. This will be controversial to most people as, for many years, saturated fats have been a bad fat that should be avoided. However, recent research has challenged that saturated fats may be no worse than other ‘healthy’ fats.

Here’s an extract from the British Heart Foundation’s Senior Dietitian’s article on the research around saturated fats:

…saturated fat came back to the top of the news agenda because research we’d helped to fund suggested there isn’t enough evidence to support current guidelines on which types of fat to eat. While the latest study didn’t show saturated fat is associated with cardiovascular disease, it also didn’t show that eating more of it is better for your heart health.​17​

There will always be a battle between fat v’s sugar.  I am not suggesting you live on high transfat takeaways or products containing hydrogenated vegetable oil for the rest of the pregnancy, but introducing ‘good’ natural fats into the diet, rather than using fat-free or diet alternatives which can be filled with refined carbs and sugar, can help gain better control of blood sugar levels​18,19​.

high fat foods

#5. Low Carb – Small serving of unrefined complex starchy carbs at every meal

Carbohydrates turn into glucose, raising blood sugar levels.  However, they are extremely important as they provide the body with energy, and carbs should not be eliminated or severely restricted from the gestational diabetes diet completely. A low carbohydrate diet has been proven beneficial in the gestational diabetes diet​20–26​.

Choose small amounts of unrefined complex starchy carbs to eat at every meal.  Carbohydrates are important as they provide energy and stop the body from entering a ketosis state​27​.

Carbohydrates can be found in many different foods. Naturally occurring carbohydrates include fruit, vegetables, milk, honey, nuts, grains, seeds and legumes.

high carb foods

There are two main types of carbohydrates:

  1. Simple – Sugar or glucose is a simple carbohydrate. Sugar naturally occurs in many foods, forming fructose in fruit, lactose in milk and sucrose in granulated sugar.
  2. Complex – Starch is a complex carbohydrate made of sugar units bonded together.  Starch occurs naturally in vegetables, grains, dried beans and peas.  When a complex carb is refined, it is processed more, and much of the fibre and goodness is stripped away, which can spike blood sugar levels higher and faster. Unrefined carbs are in their natural state and/or contain much more goodness which helps achieve lower, more stabilised blood sugar levels. These tend to be the brown, wholegrain and wholewheat versions.
Refined complex carb Unrefined complex carb
White flour Wholemeal flour
White bread Granary or wholemeal bread
White pasta Wholewheat pasta
White rice Brown or whole-grain rice
Breakfast cereals Steel-cut/pinhead porridge oats

If you are confused about carbs, don’t worry, we have a whole page dedicated to explaining carbs in greater detail.

starting point for starchy carbs
tweaking carbs

#6. Bulk with vegetables and salad

Vegetables are actually a third type of carbohydrate known as fibrous carbohydrates.  These play an important role in the gestational diabetes diet, keeping the digestive system running well and avoiding constipation. However, making better, lower-carb choices when selecting salad and vegetables is important, as some starchy or sweet ones may raise blood sugar levels too high.

Eating plenty of vegetables and salad does three things.  It fills you up so you don’t feel hungry and provides important fibre, nutrients, vitamins and minerals. Dietary fibre has also been shown to help reduce blood sugar levels​28–31​.

potatoes and legumes are carbs
All varieties of potatoes and legumes should be considered the carbohydrate of your meal rather than the vegetable counterpart because they raise blood sugar levels considerably.

Vegetables that may seem trickier to tolerate for some are tomatoes (technically a fruit), carrots, swede, parsnips, sweetcorn, peas, squashes, beetroot, peppers and canned vegetables where sugars may have been added in the canning process.

It’s also worth noting that vegetables in their raw form or cooked al dente will provide your body with more nutrients and a lower glycaemic index (have a lower impact on glucose levels) than those that have been cooked, which will be more easily digested.

#7. Drink plenty

Staying well-hydrated is very important during pregnancy and even more so if you have diabetes whilst pregnant.  Drinking water doesn’t directly lower blood sugar levels but does flush excess sugar out of your system.

Staying hydrated helps control and stabilise blood sugar levels​32​, a major part of a good gestational diabetes diet.

You should drink at least 2 litres (10 x 200ml glasses) daily. You will need to drink even more during warmer weather or if you are exercising.

I recommend drinking a glass of water with AND between every meal and snack during the day.

Tea, coffee and fizzy drinks containing caffeine should not be included in your recommended daily fluid intake as they are diuretics. Diuretics make you urinate more frequently, causing you to lose water.  

If you don’t like the taste of water, then you could try carbonated water with fresh slices of lemon and lime added to it or some sugar-free squash.

Citrus Refresher
Citrus Refresher | Gestational Diabetes UK
Check out this recipe
Citrus Refresher

Be careful when choosing drinking squashes with ‘no added sugar’; it means exactly that, no ADDED sugar, but they still contain natural sugars.  Check labels for the lowest total carbs for the best choices.

For more information on drinks, read more here.

#8. Exercise

Exercising has an insulin-like effect on cells and assists in lowering blood sugar levels​33​.

Resistance exercise has been shown to have the greatest benefits​34,35​, but it doesn’t have to be weight lifting (especially if you are not used to it); any movements such as walking, dancing, or yoga are beneficial​36–39​.

Where possible, going for a walk for 20 – 30 minutes after eating can help lower blood sugar levels. This does not have to be a brisk walk; even a comfortable stroll will be beneficial.  

If walking is painful, any movement can help, such as gentle exercise on a birthing ball.

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