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Gestational Diabetes Controversy

She has done the ungodly thing of writing a book about a topic that has no fence sitters, everyone one has an opinion, and everybody’s opinion is right.”

That’s how my interview with Robb Wolf started.

I wasn’t exactly sure if that was a compliment or something else, but I quickly found out.

If you don’t know Robb, he’s a NYT best-selling author and host of The Paleo Solution Podcast, which remains one of the top-rated health podcasts available.

Our interview went live last week and has roused up a whole ‘nother level of support for my approach to managing gestational diabetes (and a decent amount of controversy).

robb wolf gestational diabetes controversy

Listen in here (on Libsyn) or here (on Robb’s site).

(Or search on iTunes for episode 269 of The Paleo Solution Podcast.)

I have to say, this was one of my favorite podcast interviews to date. Robb asked great questions that led to an in-depth discussion of:

  • whether gestational diabetes is a “made-up” diagnosis
  • physiological changes that happen during pregnancy
  • controversy around the glucose tolerance test commonly used for diagnosing gestational diabetes (and what we can learn from pregnant horses)
  • the safety of low-carb diets and ketosis during pregnancy (which I’ve covered before, here)
  • examples of meals and food combinations I suggest for women with gestational diabetes
  • and a whole lot more…

If you enjoyed this interview about all the gestational diabetes controversies, let me know in the comments below.

As always, I appreciate your support!

Until next week,


PS – If you want to learn more about managing gestational diabetes with real food and simple lifestyle changes (and access pearls of wisdom from my years in clinical practice not found anywhere else – not even in my book), check out the Real Food for Gestational Diabetes Course.

It’s most certainly NOT what your typical dietitian would recommend, and that’s a good thing!

Manage gestational diabetes without fear.

Learn how a real food approach can help in this free video series

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Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition and exercise. Her work is known for being research-focused, thorough, and unapologetically critical of outdated dietary guidelines. She is the author of two bestselling books, Real Food for Pregnancy and Real Food for Gestational Diabetes.


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  1. Absolutely loved listening to this podcast — I’ve replayed it twice! I’m 30 weeks pregnant and was diagnosed with GD a few weeks ago much to my surprise, especially after eating mostly real food/paleo for the past couple years. I probably get about 60-90 grams of real-food carbs on a daily basis, so now I know that may be why I failed the GTT. Fasting was 78, but the three other numbers were in the 200s. At 9 weeks pregnant, my hemoglobin a1c was 5.5.

    Today, my endocrinologist suggested I may have “impaired glucose tolerance” instead of full-blown GD. Not sure exactly what that means, but I have tested blood sugars at home for nearly a week with mostly my regular meals and have had normal numbers EXCEPT for two: 92 fasting after I had a horrible night of sleep (<6 hours) and 176 after an experimental/rebellious breakfast of biscuits and gravy the size of my face. I'm in California, and upon looking at my numbers at our first meeting, the (well meaning and otherwise wonderful) dietitian wondered out loud why my GTT fasting number was so low but my others were so high. She then proceeded to offer up the Sweet Success food recommendations, telling me things like "there's no proof that coconut is good for you" and to "have a sugar free pudding" when I want something sweet. I can't even with these guidelines.

    Maybe it's denial. Maybe it's grief. But I'm feeling a bit misguided and perhaps misdiagnosed. 🙁

    • Glad you got some useful insight from the podcast, Vanessa. I can’t offer personal medical or nutrition advice in this format, but I wish you luck in getting to the bottom of this (at the very least, it’s better to have great blood sugar numbers than uncontrollably high ones). Hang in there. 🙂

  2. Lily. I’m sooo interested in this area. I’m a lactation consultant / midwife in Newcastle Australia and we are seeing blown out positives in our women testing with Gtt at 28 weeks They can’t control bsl well with conventional diet . My beautiful daughter in law who is a healthy /beautiful weight / pregnant mummy has been diagnosed with GD 2weeks ago and is now on metformin slow release bd . They only gave her 1 week with diet modifications that left her starving but she still tested high especially after breakfast . ( toast(1)egg avocado tomato ???? Why . If she ate cereal low carb her sugars recorded much higher ??? Sometimes fasting higher ( but just higher than requirement)Here in Australia our fasting bsl needs to be 5 mmol.or under . Post meals 2 hrs up to 6.7 mmol.or below . Help . I have ordered your book but it’s not come 2 weeks +now Dodgy eBay seller I think ?? They said they had item in Australia /Sydney . Could you direct me to book store for distribution Lily . Thankyou . Hope the talk goes really well xx Lou Macintyre .?

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