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Cutting carbs can improve blood sugar control in pregnant women with gestational diabetes, but it may also mean missing out on key nutrients. A new analysis found that eating fewer than 120 g/day of carbs reduced time spent with high glucose levels — yet also lowered intake of fibre, B vitamins, and essential minerals. The trade-off raises important questions about dietary quality during pregnancy.
A new analysis of the DiGest trial offers a nuanced look at low-carbohydrate diets in gestational diabetes mellitus (GDM). Among 215 pregnant women with a BMI of 25 or higher, those eating fewer than 120 g/day of carbs spent significantly less time with elevated blood glucose compared to those on a standard carb intake — without an increase in dangerously low glucose episodes. That's a meaningful win for glycaemic control.
But there's a catch. Women on very low-carb diets also consumed notably less fibre, thiamine, riboflavin, niacin, vitamins B6, B12, and E, as well as calcium, magnesium, potassium, and zinc — all nutrients critical during pregnancy. Infants born to mothers in the very low-carb group also had lower birth weight centiles, though rates of large- or small-for-gestational-age births didn't differ significantly.
Key Takeaways:
Why it matters: For clinicians managing GDM, this study signals that modest carb and calorie restriction — rather than aggressive carb cutting — may offer the best balance of blood sugar control and nutritional adequacy for both mother and baby.
