New research has demonstrated that a lower calorie diet in late pregnancy is both safe and beneficial for women with gestational diabetes who are living with overweight or obesity. Reduced-energy diets improve long-term outcomes in type 2 diabetes, but to date, have been untested in women with gestational diabetes.
The Dietary Intervention in Gestational Diabetes (DiGest) trial was led by Prof Claire Meek at the Universities of Leicester and Cambridge, UK, and was funded by Diabetes UK. Investigators aimed to identify if weight loss in pregnancy improves perinatal outcomes in gestational diabetes by conducting a multicentre parallel, randomised controlled trial of energy restriction in women with singleton pregnancies, gestational diabetes, and body mass index ≥25.
The trial enrolled a total 425 participants, who were randomised to receive either a standard energy control diet of 2,000kcal or reduced-energy intervention diet of 1,200kcal. The results showed that a reduced calorie diet during the third trimester of pregnancy was safe for women with gestational diabetes and their babies.
Results
Women lost a mean of 3kg in both groups; however, additional benefits were observed in the intervention group. Women following a reduced energy diet were less likely to need long-acting insulin to manage their blood sugar levels. They also demonstrated lower blood sugar levels and 7 per cent more time in range.
The intervention group also had improved blood pressure levels and a 48 per cent lower risk of delivering a large baby, which is linked to safer births and reduced risks of obesity and type 2 diabetes for the child later in life.
The research team also found that women who lost weight in late pregnancy maintained their weight loss and had improved blood sugar levels at three months post-delivery.
Commenting on the trial, Prof Meek said: “We know that reduced calorie diets promote weight loss and improve blood sugar levels for people with type 2 diabetes, but this has never before been tested as a way to help women with gestational diabetes minimise weight gain…. If we used a reduced calorie diet for this group nationally, we predict one-in-eight women with gestational diabetes could reduce their need for insulin, which we estimate could benefit up to 13,000 women every year.”
Results from the DiGest trial were recently published in Nature Medicine.
Reference
Kusinski LC, Jones D, Atta N, et al. Reduced-energy diet in women with gestational diabetes: The dietary intervention in gestational diabetes DiGest randomised clinical trial. Nat Med 2025;(31):514-523
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