Traditional GDM management is an evidence based approach which largely focuses on monitoring and treatment of maternal hyperglycaemia. Medical Nutrition Therapy (MNT) is first line therapy, although evidence on the optimal approach is limited. Other non-glycaemic variables may be confounders in randomised controlled trials investigating dietary interventions for GDM management. These same variable may also contribute to variations in therapeutic and pregnancy outcomes. Pre-pregnancy body mass index (BMI) and excessive maternal weight gain may drive insulin resistance and maternal hyperglycaemia. We conducted several studies investigated the relationship between pre-pregnancy BMI, maternal weight gain, and therapeutic and neonatal outcomes in women with GDM. One study of 3281 singleton GDM pregnancies (1992-2015) (1) women found that excessive gestational weight gain independently increased fasting plasma glucose on the oral glucose tolerance test. Further, continued excessive gestational weight gain during GDM management increased the risk of large for gestational age infants and insulin requirements. A further study (n=1034) involved women receiving a personalised weight targets, with supporting individualised dietary advice from a dietitian (2). Women who exceeded or gained less than their personalised target, had less favourable outcomes compared to those who achieved their target. The study findings suggested that weight management after gestational diabetes diagnosis does not appear to be too late, and provides additional benefits to glucose-lowering treatment. We also conducted a national survey which found that most dietitians delivering MNT for GDM provide precise guidance on carbohydrate intake – focusing on controlling post prandial blood glucose levels (3). Further, although a limited number of dietitians reported provision of maternal weight gain advice and routine weighing over 10 years ago, rates are now increasing (3). However as most weight is gained before GDM presentation, there are opportunities to support healthy eating, and maternal weight gain from earlier in pregnancy. This body of evidence shows that weight management before and during GDM management can improve therapeutic and pregnancy outcomes in addition to benefits achieved by management of maternal hyperglycaemia.