Evidence-Based Nutrient Recommendations

Gestational Diabetes

Pregnant women who did not have diabetes before they were pregnant, and who develop elevated blood glucose (sugar) when they are pregnant, have a condition called gestational diabetes. As many as 9% of pregnant women in the United States have gestational diabetes (DeSisto2007). There are no reports of how many vegan women develop gestational diabetes.

Although the symptoms of gestational diabetes go away after the baby is born, a woman who has had gestational diabetes is at a higher risk of having type 2 diabetes later in life (National Institutes of Health, 2017).

Gestational diabetes treatment aims to keep the mother’s glucose levels in a normal range, which reduces the risk of pregnancy complications like having a very large baby and difficult delivery. Additionally, if the mother’s glucose is not well controlled during pregnancy, her child can be at increased risk of having obesity and of having type 2 diabetes as an adult.

A somewhat low carbohydrate diet—about 45% of calories—is one of the ways to keep the mother’s blood glucose levels under control. Glucose levels of women with gestational diabetes are typically high in the morning and so the carbohydrate content of breakfast is limited, often to 15-30 grams (Shields, 2015). Breakfast should mainly provide protein and fat and this can be a change for some vegan women who may be used to eating a breakfast of mostly carbohydrate like toast and fruit. A better option for breakfast for a vegan woman with gestational diabetes could be 3/4 cup of oatmeal (21 grams of carbohydrate) with 2 tablespoons of peanut butter for a total of 28 grams of carbohydrate and 12 grams of protein.

For women with gestational diabetes, fruit is typically avoided in the morning because fruit sugar is absorbed quickly and can cause a spike in blood glucose. Fruit is often limited to 1 small serving a few times later in the day.

Ideally, each woman’s daily blood glucose levels would be used to help to determine how much carbohydrate each meal should contain. In general, women with gestational diabetes are advised to eat 3 meals and 2-3 snacks per day so that they’re eating every 2-3 hours. Carbohydrate sources should be mainly whole foods like whole grains, beans, and vegetables and should be spaced throughout the day.

Concentrated sources of sugar such as cake, cookies, candy, soda, fruit juice, energy drinks, and sweeteners (such as sugar, molasses, maple syrup, agave) should be avoided (Shields2015).

Management of gestational diabetes should be individualized and women with gestational diabetes should consult with a registered dietitian who is experienced in gestational diabetes so as to develop a customized eating plan.


Last updated March 2018

DeSisto CL, Kim SY, Sharma AJ. Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis 2014;11:130415.

NIH/NIDDK. Gestational diabetes. 2017.

Shields L, Tsay GS. Editors. California Diabetes and Pregnancy Program Sweet Success Guidelines for Care. Developed with California Department of Public Health; Maternal Child and Adolescent Health Division; revised edition, Chapter 7. Updated September 2015.