Prediabetes in Pregnancy: Now What Do I Eat?

Note: The Pregistry website includes expert reports on more than 2000 medications, 300 diseases, and 150 common exposures during pregnancy and lactation. For the topic Diabetes, go here. For the topic Gestational Diabetes, go here. For the topic Diabetes Insipidus, go here. These expert reports are free of charge and can be saved and shared.


Diabetes mellitus is a disease in which levels of glucose (sugar) in your blood are too high. Eventually, this excess sugar will impair normal, healthy functioning of your body and can lead to blindness, kidney disease, and heart problems.

Diabetes develops when you do not have enough insulin—the hormone that allows your body to use the glucose in the foods you eat for energy. You may not have enough insulin because your body can’t make any insulin on its own (called type 1 diabetes) or because your body can’t make enough insulin or it can’t use the insulin it makes (called type 2 diabetes). Type 1 diabetes is usually diagnosed in childhood: its development is largely due to genetics and there is no prevention or cure; insulin therapy is the only treatment. Type 2 diabetes develops later in life, usually as a result of being overweight and poor dietary and exercise habits; sometimes, other diseases and medications can cause type 2 diabetes.

Gestational diabetes is diabetes that develops during pregnancy: the insulin demands of pregnancy are simply too high for your body to keep up. Gestational diabetes can lead to problems for you and your baby, including high birth weight, preterm birth, respiratory distress, and type 2 diabetes later in life.

If you have already been diagnosed with diabetes before pregnancy, you will need to pay careful attention to your diet, activity, and blood sugar levels while you are pregnant to keep yourself and your baby healthy.

“Prediabetes” is a term that is used to label someone as “almost” having diabetes: you don’t meet the criteria for diabetes, but your blood sugar results are higher than normal and you are at risk for developing diabetes (either type 2 or gestational diabetes). The good news, if you are told you have “prediabetes,” is that you still have time to change your habits and lifestyle and reverse the risk of diabetes.

One of the most important things you can do to prevent diabetes is eating a healthy diet. Not only should you pay attention to what you eat, but pay attention to how much you eat: choose nutrient-rich, low-calorie foods in appropriate portion sizes. Physical activity is also important, and all women should engage in regular exercise at a level that is appropriate for them.

Carbohydrates (a major nutrient group that includes starches and sweets and the primary source of glucose in your diet) should make up only half of your total calorie intake for the day. Fruits and vegetables, cereals, breads, beans, and pastas can all be healthy carbohydrate choices in moderation, but be sure to choose ones that are high in fiber. (Fiber helps keep blood sugar levels down and helps with heart and digestive health, as well.) Healthy carbohydrate choices include whole-grain breads and cereals, non-starchy vegetables, lentils, and chickpeas.

Proteins are another important part of your diet if you have prediabetes: choose lean, low-fat proteins such as chicken and turkey, fish that contains low levels of mercury, eggs, nuts, and low-fat yogurt. Other good protein choices include beans, seeds, quinoa, legumes, and tofu. Milk and other dairy products can be consumed in moderation.

Unsaturated fats can be included in a healthy diet. Good sources of these “healthy” fats are olive oil, peanut oil, avocados, seeds and nuts, salmon, sardines, tuna, and chia seeds.

The goal of eating when you have prediabetes is to maintain healthy, steady blood sugar levels. The levels shouldn’t spike too high or drop too low: eat small meals and snacks throughout the day to prevent large variations in your blood sugar levels. Avoid eating too many carbohydrates at one time and combine carbohydrates with protein or healthy fat.

When you are eating to prevent diabetes, avoid sugary foods as much as possible (cakes, candies, soft drinks, fruit juices with added sugar). Also avoid highly refined and highly processed foods such as white bread, white pasta, condiments such as dressings and ketchup, fast food, and alcohol.

If your doctor tells you that you have prediabetes, you should seek the help of a nutritionist or a dietician who can help you plan a healthy diet and exercise plan. Making simple changes to your lifestyle can reverse health risks associated with diabetes and ensure a healthy pregnancy for you and your baby.

Jennifer Gibson
Dr. Jennifer Gibson earned a Bachelor of Science degree in Biochemistry from Clemson University and a Doctor of Pharmacy degree from the Medical College of Virginia School of Pharmacy at Virginia Commonwealth University. She trained as a hospital pharmacist and is the author of clinical textbooks, peer-reviewed journal articles, and continuing education programs for the medical community, as well as a contributor to award-winning healthcare blogs and websites. In her free time, she enjoys running, reading, traveling, and spending time with her family.

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