Getting diagnosed with gestational diabetes (GD) can feel like someone just handed you a new rulebook… without the rules. One minute you're pregnant and trying to eat "healthy," and the next you're wondering: What can I even eat now?
So we asked registered dietitian Ruth Hia to break down what to focus on in week 1—without the perfection pressure. Here's what she recommends.
Looking for the full GD basics + what to expect? Check out our newly diagnosed guide.
Quick note: This is general education, not medical advice. Always follow your care team's guidance.
Gestational diabetes (GD) is a condition in which blood glucose levels (your blood sugar) become elevated during pregnancy. This happens because pregnancy hormones can increase insulin resistance — basically, your body becomes less responsive to insulin, so you need more insulin to keep your blood sugar in a normal range.
Most pregnant women find out after a routine blood test like the oral glucose tolerance test. And if you’re sitting there with a million questions after an abnormal result… you’re in very good company.
The reassuring news is that for most women, blood glucose levels return to normal after delivery. Still, having GD does increase the risk of developing type 2 diabetes later in life (and in future pregnancies), so supporting healthy blood glucose management through nutrition and lifestyle matters during pregnancy and beyond.
And just to say it out loud: GD is influenced by many factors (including hormones and risk factors), so this isn’t a willpower thing.
In the first week, the goal is not perfection—it's learning how your body responds to food.
Think of your blood sugar readings as information, not a judgment. You're collecting clues so you (and your care team) can see patterns and make small, sustainable tweaks.
Before getting into specific foods, it helps to understand the three macronutrients: carbohydrates, protein, and fat.
Carbohydrates are the macronutrient that most directly raise blood glucose levels. That's why they get the most attention in GD.
Protein and fat don't raise blood glucose in the same way. They help slow digestion, support satiety, and can help keep post-meal blood glucose more stable when paired with carbs.
A source of carbohydrates (bread, rice, fruit, etc.)
A source of protein (eggs, chicken, fish, yogurt/Greek yogurt, etc.)
A source of fat (avocado, nuts, olive oil, etc.)
A source of fiber (non-starchy vegetables like leafy greens, broccoli, zucchini, etc.)
Portion sizes matter most for carbs, because they have the most direct impact on blood glucose.
If you're still hungry after a meal, try increasing:
Protein
Healthy fats
Non-starchy vegetables
…rather than adding extra carb portions.
No.
Carbohydrates are important during pregnancy and support fetal growth and development. The goal isn't to eliminate carbs—it's to balance them.
Focus on:
Pairing carbs with protein, fat, and fiber
Spacing carbs throughout the day (instead of having a big carb load at once)
Choosing higher-fiber carb sources when possible
Many people do well with:
3 meals per day
2–3 snacks per day
Regular intake can help reduce big swings in blood glucose and support steadier readings.
These are some of the most common patterns that happen early on:
Skipping meals to "keep numbers low" (often backfires and can lead to later spikes)
Eating carbohydrates alone without protein or fat
Trying to be overly restrictive or "perfect"
This is a learning process. Your readings are feedback, not a measure of success or failure.
That's expected.
Blood glucose is influenced by many factors beyond food, including:
Hormones
Sleep
Stress
Timing of meals
It often takes time (and small adjustments) to figure out what works best for your body.
Here's a general example (your needs may vary):
Breakfast: eggs + whole grain toast + avocado
Snack: apple + peanut butter
Lunch: chicken, rice, and vegetables
Snack: yogurt + nuts
Dinner: salmon, potatoes, and a salad
If you try something like this and your numbers aren't where you want them yet, that doesn't mean you "failed." It just means you learned something useful.
You'll find more 'what to eat in a day' guides with 3 meals + 3 snacks on each, plus shopping lists for what to buy in our shopping guides.
Gestational diabetes is something I see very often in my practice. It's one of the most common reasons women reach out during pregnancy. Most of my patients are focused on improving blood sugar control, and many are surprised by how manageable it becomes once they understand how to structure their meals and snacks.
Most women reach out right after being diagnosed, often feeling overwhelmed and unsure what to eat.
I also work with many who come earlier if they are already prediabetic prior to pregnancy, if they've had GDM in a previous pregnancy, or have a family history of type 2 diabetes or GDM.
One thing that has really shaped how I work with gestational diabetes clients is how often I see women trying to "eat as little as possible" to keep their numbers low.
I worked with someone who was skipping carbohydrates at meals and avoiding snacks because she was worried about blood sugar spikes. Her numbers were actually becoming more unpredictable, and she felt constantly hungry and stressed.
Once we shifted to more consistent meals and started pairing carbohydrates with protein and fat, her numbers became more stable—and just as importantly, she felt more relaxed around food.
That experience reinforced for me that gestational diabetes management is not about restriction, but about balance and consistency.
Gestational diabetes can feel overwhelming at first, but with consistent, supportive nutrition strategies, it becomes manageable.
Small, sustainable changes are often the most effective.
If this feels like uncharted territory, you do not have to navigate it alone. Working with a registered dietitian can provide personalized guidance, structure, and reassurance as you learn what works best for your body during pregnancy.
Most insurance plans cover medical nutrition therapy, making this type of support accessible for many people. You deserve individualized care that helps you feel confident and supported—not confused or restricted.
If you would like guidance, you can learn more here.
— Ruth Hia, Registered Dietitian
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