Researchers followed nearly 4,300 women who had gestational diabetes during pregnancy to see if certain eating patterns increased their risk of developing type 2 diabetes later. Over 28 years, women who ate more inflammatory and insulin-spiking foods had a significantly higher chance of developing diabetes. Women eating the most inflammatory foods were 32% more likely to develop diabetes, while those eating the most insulin-spiking foods were 44% more likely. This study suggests that women with a history of gestational diabetes may benefit from paying special attention to their diet to prevent type 2 diabetes.

The Quick Take

  • What they studied: Whether eating foods that cause inflammation or cause blood sugar spikes increases the risk of developing type 2 diabetes in women who had gestational diabetes during pregnancy
  • Who participated: 4,318 women from the Nurses’ Health Study II who had gestational diabetes. Researchers tracked them from 1991 to 2019, collecting information about what they ate and monitoring who developed type 2 diabetes
  • Key finding: Women who ate the most inflammatory foods had a 32% higher risk of developing type 2 diabetes, and women who ate foods that caused the most insulin spikes had a 44% higher risk, compared to women eating the least of these foods
  • What it means for you: If you had gestational diabetes, being mindful of eating less inflammatory and processed foods may help reduce your chances of developing type 2 diabetes. However, diet is just one factor—talk to your doctor about a personalized prevention plan

The Research Details

This was a long-term follow-up study where researchers tracked the same group of women over many years. The women were all nurses, which helped ensure good record-keeping and follow-up. Researchers asked women about their eating habits using detailed food questionnaires and then calculated two special diet scores: one measuring how inflammatory their diet was and another measuring how much their diet caused blood sugar and insulin spikes. They then watched to see who developed type 2 diabetes over the next 28 years.

The researchers used a statistical method called Cox regression to figure out whether women with higher inflammatory or insulin-spiking diet scores were more likely to develop diabetes. They adjusted their results to account for other important factors like body weight, physical activity, and family history of diabetes, so they could isolate the effect of diet alone.

This approach is strong because it follows real people over a long time and collects detailed information about their eating habits before they develop diabetes, which helps prove that diet came before the disease.

This study design is important because it follows women forward in time, starting before they develop diabetes. This helps prove that the diet pattern actually came before the disease, not the other way around. By focusing specifically on women with a history of gestational diabetes, the researchers identified a group at particularly high risk who might benefit most from dietary changes.

This study has several strengths: it followed a large group of women for nearly 30 years, used detailed food questionnaires that have been tested and validated, and adjusted for many other factors that could affect diabetes risk. The women were all nurses, which may mean they were more health-conscious than the general population. The study also measured actual blood markers like insulin and cholesterol in a subset of women, which strengthens the findings. However, the study relied on women remembering and reporting what they ate, which can have some errors.

What the Results Show

During the study period, 1,037 women out of 4,318 developed type 2 diabetes. Women whose diets had the highest inflammatory potential (top 20%) were 32% more likely to develop diabetes compared to women with the lowest inflammatory diets (bottom 20%). This difference was statistically significant, meaning it’s unlikely to be due to chance.

The results were even stronger for insulin-spiking foods. Women eating the most insulin-spiking foods (top 20%) were 44% more likely to develop diabetes compared to those eating the least (bottom 20%). This suggests that foods causing rapid blood sugar and insulin spikes may be particularly harmful for women with a history of gestational diabetes.

When researchers looked at blood tests from women who hadn’t yet developed diabetes, they found that women with higher inflammatory diet scores had higher insulin levels and lower levels of HDL (the “good” cholesterol). Women with higher insulin-spiking diet scores had even higher insulin and C-peptide levels (a marker of insulin production), suggesting their bodies were working harder to control blood sugar.

The study found that inflammatory diet patterns were linked to unfavorable cholesterol levels, specifically lower HDL cholesterol, which is a risk factor for heart disease. Both inflammatory and insulin-spiking diet patterns were associated with higher insulin levels, suggesting these diets stress the body’s ability to regulate blood sugar. These findings suggest that the harmful effects of these diets go beyond just diabetes risk and may affect overall heart health.

This study builds on previous research showing that inflammatory foods increase diabetes risk in the general population. However, this is one of the first studies to specifically examine these dietary patterns in women with gestational diabetes, a group known to be at much higher risk for developing type 2 diabetes later. The findings align with other research showing that processed foods and foods with high sugar content increase diabetes risk, and extend that knowledge to this specific high-risk group.

The study relied on women reporting what they ate, which can be inaccurate or incomplete. The women studied were mostly nurses, who may be more health-conscious than the general population, so results might not apply equally to all women. The researchers couldn’t prove that diet alone caused the diabetes—other unmeasured factors could have played a role. Additionally, the study couldn’t determine exactly which specific foods were most harmful, only that overall dietary patterns mattered.

The Bottom Line

Women with a history of gestational diabetes should consider reducing foods that cause inflammation and rapid blood sugar spikes, such as refined grains, sugary drinks, processed meats, and highly processed foods. Instead, focus on whole grains, vegetables, fruits, legumes, and lean proteins. This recommendation has moderate-to-strong evidence from this study. However, diet is just one part of diabetes prevention—regular physical activity, maintaining a healthy weight, and regular check-ups with your doctor are equally important.

This research is most relevant for women who had gestational diabetes during pregnancy, as they have a 50% or higher lifetime risk of developing type 2 diabetes. Women with a family history of type 2 diabetes or those who are overweight should also pay attention to these findings. Anyone concerned about diabetes risk should discuss personalized prevention strategies with their healthcare provider. This research is less directly applicable to women without a history of gestational diabetes, though the general principles about inflammatory foods may still be beneficial.

Changes in blood sugar control and insulin levels can begin within weeks of dietary changes, but meaningful reductions in diabetes risk typically take months to years to become apparent. Most people should expect to see improvements in energy levels and blood sugar stability within 2-4 weeks of making dietary changes. However, preventing diabetes is a long-term commitment, and benefits accumulate over years of consistent healthy eating.

Want to Apply This Research?

  • Track daily servings of processed foods, refined grains, and sugary drinks versus whole grains, vegetables, and legumes. Set a goal to reduce inflammatory foods by 25% each week and increase whole foods by the same amount. Monitor how you feel (energy levels, hunger patterns) alongside these dietary changes.
  • Use the app to log meals and receive real-time feedback on inflammatory content. Set reminders to swap one processed food item daily with a whole food alternative. Create a shopping list feature that highlights anti-inflammatory options when planning meals.
  • Weekly review of dietary inflammatory scores, monthly check-ins on energy and hunger levels, and quarterly assessments of progress toward reducing processed food intake. If available, correlate with periodic blood sugar or insulin measurements from healthcare visits to track physiological improvements.

This research suggests associations between dietary patterns and diabetes risk but does not prove that changing diet will prevent diabetes in all women. Women with a history of gestational diabetes should work with their healthcare provider or a registered dietitian to develop a personalized prevention plan. This information is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your doctor before making significant dietary changes, especially if you have existing health conditions or take medications that affect blood sugar.