Dietary intake and physical activity

All pregnant women with diabetes should be referred to an experienced accredited practising dietitian for education about dietary intake and nutrition during pregnancy. Women should also be advised of the recommended weight gain appropriate for their prepregnancy body mass index (BMI), see Recommended weight gain in singleton pregnancies.

Emphasise the need to meet the nutritional requirements of pregnancy, including adequate carbohydrate intake (preferably with low glycaemic index [GI]) spread over the day. Over-restriction of dietary intake is not advised because the growth of the fetus may be adversely impacted. See Nutrition and weight gain recommendations during pregnancy for women with pre-existing diabetes.

Physical activity and exercise (eg 20 to 30 minutes moderate-intensity exercise on most or all days of the week) during pregnancy improves cardiovascular health and general fitness while reducing risk of complications such as pre-eclampsia and caesarean delivery. Anecdotally, physical activity (eg walking for 10 to 15 minutes) after a meal reduces the 1-hour postprandial blood glucose concentration peak.

Hyperglycaemia in pregnancy (including gestational diabetes) can be managed by lifestyle modification (dietary intake and physical activity) in more than 50% of pregnant women.