Low carb diet in pregnancy

Hello everyone,

I am thinking about having baby #2 and am wondering about trying to eat a low (or lower) carb diet this time around. Baby #1 was big (9 lb 13 oz at 37 weeks) despite good control (A1cs in the low 6s and high 5s the whole pregnancy). I'm wondering if limiting my carb intake will help me to minimize blood sugar fluctuations and help avoid chasing high blood sugars.

However, I know that most OBs, nutritionists, etc are not too keen on pregnant women limiting their carb intake. So I was curious to hear whether anyone has done this successfully, with or without the support of your OB or endo.

I think there have been posts about this before, but I couldn't find them, and anyway I thought it might be a good topic to bring up again.

Looking forward to hearing your experiences!


From what I understand, going too low causes protein and/or ketones to “spill” into your urine. There is some debate about whether this is OK, but let me just warn you that protein in the urine is one of the signs they watch for when they suspect pre-eclampsia. So even if you believe ketosis is safe (as do many low-carbers), I’d be a little bit worried a out raising the risk of a pre-e diagnosis. (When I got badly swollen, they were so sure that I must have pre-e despite perfect blood pressure that they had me do a 24-hour urine sample to look for protein after my routine in-office sample showed none.) Just FYI.

I doubt a LOW carb diet is a great idea, but simply reducing carbs probably isn’t a terrible idea. I’d probably talk to one of my doctors a out a safe lowish carb goal.

Are you on the positive diabetic pregnancy mailing list (Yahoo group)? There are a few low carb / paleo women there and a few discussions about it.

I ate high carb in pregnancy (185g / day) and had low ketones in my urine every morning. So I don't know what it depends on.

I don't want to go low carb, but I have heard that many women who have and have done great with it!

Thanks for the replies! I should clarify; I don't think I could handle a truly low-carb diet, I was just thinking of eating fewer carbs than I did in my last pregnancy (which was between 150-200g/day). I guess I was thinking somewhere around 100g/day, which I think is below what is recommended in pregnancy.

I also had small-moderate ketones in my urine last time, and my OB wasn't concerned. She eventually told me I could stop testing. I never really understood what that was all about.

And thanks for the heads up about the Yahoo group; I'll check it out.

Why kind of foods are you thinking of eating?

I used to eat reasonably low carb but since I have stopped eating any food with listeria links I find my options are limited unless I make it all myself.

I havent had the energy to do this so far

My first pregnancy my Dr tried to control me with very little carbs. I always had very high ketones and I ended up haveing a miscarraige(not saying this is why). I did read about going low carb and having high ketones can be bad for the baby.

Hey Kristin, I finally got around to looking for that Yahoo group and can't find it--is that the exact name? Can you send me a link or anything? Thanks!

Click here for the group.

The link didn't work. :( It said, "document not found."

Sorry. You can send an email to this email address and that will subscribe you to the Yahoo Group and then you should get a link to it sent to you:

I ate fairly low carb throughout my pregnancy (80-120g) even though it made my nutritionist crazy. I was so sensitive to carbs that I had to cut out most grain products entirely. If I did eat many carbs with a meal it had to be balanced with fat and protein. I was able to keep my a1c's between 5-6 with no ketones present. My endo and ob were both fine with this approach since my numbers were good.

80-120g/day is probably about what I'd shoot for, too. I have a feeling it will make my nutritionist crazy if I do it, too. :) I'm not pregnant yet, but for the last few weeks I've cut out all sugar and other sweeteners and most grains and started eating more vegetables (I already ate a lot by American standards). While my blood sugars haven't been as amazing as I thought they'd be, they're better than usual and I'm definitely seeing less fluctuation. So I'm inspired to keep going with it. I can't wait to see what the nutritionist says!

I ate more carbs (180g per day), but never more than 50g at a single time. Also, I was allowed only 10g of fast acting carbs at a time (meaning milk products and fruit) and NONE at breakfast time. At my 4pm snack (when insulin resistance was lower and I at e 20g of fast acting). I also weighted all carbs that I ate. Not everyone did this extreme diet (and many who didn't ended up with better A1cs than me!), but I liked it and will do it again next time!

I used to claim that I didn't see a different in a spike from chocolate or from bread, i.e. 10g=10g, but in my experience healthy carbs made things easier to manage and were better for me and my son too! It was a hard adjustment at first, but after a while I didn't even miss unhealthy foods. Now if I only had stuck to that diet after the birth!!! (Don't even ask...)

I totally agree. I also used to make that claim. As I have paid so much closer attention during my pregnancy and now as I look towards the next one, I have found that not to be true (for me, anyway). It's also true that everyone is different, and just because something is "healthy" or low on the glycemic index, it doesn't mean that it won't be trouble for your blood sugars. (I, for example, really just can't eat oats of any kind unless I want to see a spike and then a low later).

I have to say that I feel really grateful for the pregnancy experience and especially now that I'm experimenting more with my diet. I have learned so much that I wouldn't have otherwise.

I really think your tastebuds and expectations change once you change your diet. It's pretty cool to experience.

Yes, I experienced the same thing about changing tastebuds and expectations. I didn't miss the junk when I was pregnant and for a while afterwards. But now I do. Time to get back in gear.

P.S. oats are the same for me.

I know, as soon as you let yourself slip a little, you start craving it again. Weird how that works.

I wonder what the deal is with oats, because SO many people claim that oatmeal keeps them going for hours, and that steel cut oats are the best because they don't spike your blood sugar... but that just isn't true for me. Quirks of digestion? Who knows?! (I also think that the people who say that oats are really filling probably eat way more than I would be able to eat).

The oat thing is weird. I couldn’t even look at let alone eat oats or popcorn during my pregnancy, but now I eat oatmeal almost every morning without much of a fluctuation. I have really fallen off the healthy eating wagon. There were so many foods I missed during the pregnancy (ie chocolate, ice cream, etc). It’s hard not just grabbing unhealthy convenience foods when trying to figure out how to take care of a new baby. Time to straighten up my diet.

That is weird! I think it was worse for me when I was pregnant, but it hasn't gone away.

I know I didn't do very well managing my bgs after the baby was born. One thing that did REALLY help me, foodwise (for anyone who's pregnant and reading this) was making a lot of healthy meals a couple of months before my due date and putting them in the freezer. I bought a couple of cookbooks especially tailored to freezing. The one I liked the most is called _Make Ahead Meals Made Healthy_. I would usually try to cook two meals at once, and we'd eat part of one for dinner that night and I'd freeze the rest.

I am around 12 weeks pregnant and was doing low carb, probably ate less then 20g a meal,and I had AMAZING blood sugars but every time I went to the OB I always had large ketones and it freaked them out a little. My Dex graphs were so pretty never over 130 and I was able to control any lows by just turning my pump down and that was only around 50ish. Now the past 2 days I have been eating more carbs like the OB wants but my blood sugars are INSANE! I have massive fluctuations with double arrows up and down, I haven’t been able to catch my lows like before and I have had several in the 20’s and 30’s. I am just SO frustrated. I feel like these fluctuations are worse for the baby and I just don’t know what to do. I really like the control I have had low carb.