8 Gentle Pilates Moves for Gestational Diabetes (That Actually Feel Good)

Exercise content by Jamie Askey, RN. 

Introduction

When my doctor first suggested adding strength training to help manage my gestational diabetes, I'll admit my first thought was "Oh suuuuure, I’ll get right on that." Between the fatigue, the blood sugar monitoring, and just generally feeling like my body wasn't entirely my own anymore, the idea of lifting weights or doing intense workouts felt like a big ask.

But then I discovered that Pilates—specifically low-impact, pregnancy-modified Pilates—was exactly what strength training could look like during this time. Not grueling. Not exhausting. Just intentional, controlled movement that made my body feel capable rather than depleted.

Research supports what I experienced firsthand: Pilates is specifically recommended as an effective strength exercise for gestational diabetes management. The controlled movements help build muscle strength, which improves your body's ability to use insulin effectively, while the focus on core stability and posture helps with the physical challenges of pregnancy itself.

These eight moves became my go-to routine when I needed a little movement that didn’t require more energy than I had to give. They're designed to work with your pregnant body, not against it.

(Looking for more like this? Check out The Gentle Movement Guide: Safe Exercise for Gestational Diabetes That May Help Lower Blood Sugar.) 

Why Pilates Works for Gestational Diabetes

Before we dive into the specific moves, it's worth understanding why Pilates is particularly effective for blood sugar management. The controlled, sustained movements engage muscles in ways that help them use glucose for energy both during and after your workout. Unlike high-impact exercise that can feel overwhelming during pregnancy, Pilates offers strength-building benefits without the joint stress or exhaustion.

The beauty of Pilates for gestational diabetes is that it's inherently modifiable—you can adjust each movement based on how you're feeling on any given day, which makes it sustainable for regular practice.

The 8-Move Routine

1. STANDING ROLL DOWN: GENTLE SPINE ARTICULATION

This move helps decompress your spine and provides a gentle warm-up for your entire back.

How to do it:

• Stand with feet hip-width apart, shoulders relaxed
• Inhale deeply, then exhale as you slowly roll forward, chin to chest
• Roll down vertebra by vertebra, keeping knees slightly bent
• Let your arms hang heavy
• Inhale at the bottom, then exhale as you roll back up, stacking one vertebra at a time

Why it helps: The controlled movement warms up muscles and increases circulation, preparing your body to use glucose effectively during the rest of your workout.

Modification: If rolling all the way down feels too intense, only go as far as comfortable, or place your hands on your thighs for support.

2. PELVIC TILTS: CORE CONNECTION

This fundamental Pilates move helps you find and engage your deep core muscles, which are essential for both blood sugar management and pregnancy comfort.

How to do it:

• Stand with feet hip-width apart, hands resting on hips
• Inhale to prepare
• Exhale as you tilt your pelvis forward, tucking tailbone under
• Engage your abdominal muscles without holding your breath
• Inhale to release back to neutral
• Repeat 8-10 times

Blood sugar benefit: Core engagement activates large muscle groups that are efficient at using glucose for energy. 

Feel it here: You should feel gentle work in your lower abs and a stretch in your lower back.

3. MODIFIED SIDE LEG LIFTS: HIP STRENGTH AND BALANCE

This standing exercise improves balance while strengthening the muscles that support your changing center of gravity.

How to do it:

• Stand tall, holding a chair or wall for support (if you need it) 
• Shift weight to left leg, keeping a slight knee bend
• Inhale to prepare
• Exhale as you lift right leg out to the side (keep it straight or slightly bent)
• Keep hips level—don't lean away from the lifting leg
• Inhale to lower with control
• Do 8-10 reps, then switch sides

Why it matters: Strong hip muscles help with stability as your belly grows, and working one side at a time challenges your balance, which engages more muscle fibers.

Pregnancy note: As you progress in pregnancy, you might need more support from your chair or wall—that's completely normal and expected.

4. SEATED SPINE TWIST: MOBILITY AND BREATH

This seated twist helps maintain spinal mobility while practicing coordinated breathing, which can be calming for stress-related blood sugar fluctuations.

How to do it:

• Sit on a mat with legs extended (or bent if that's more comfortable)
• Bend right knee and place right foot outside of left thigh
• Inhale to lengthen your spine
• Exhale as you twist right, left hand on right knee, right hand behind for support
• Keep shoulders relaxed, don't force the twist
• Inhale to return to center
• Repeat 5-6 times each side

Important: Twist from your ribcage and upper back, not from your belly. Keep the twist gentle—you're mobilizing, not wringing out.

Blood sugar connection: The rotational movement engages oblique muscles while the breathing pattern helps activate your parasympathetic nervous system, which supports better glucose regulation.

5. MODIFIED CAT-COW: SPIRAL FLEXIBILITY

This classic yoga-Pilates hybrid feels amazing during pregnancy and provides gentle core work without putting pressure on your belly.

How to do it:

• Come onto hands and knees, wrists under shoulders, knees under hips
• Inhale: Drop belly toward mat, lift chest and tailbone (Cow)
• Exhale: Round spine, tuck chin, engage core (Cat)
• Move slowly and smoothly, coordinating with breath
• Repeat 8-10 times

Why it's perfect for pregnancy: Relieves back pressure, gently works abdominals, and the hands-and-knees position takes weight off your spine.

Timing tip: This move is particularly effective after meals as a gentle post-eating movement to help with blood sugar.

6. STANDING INNER THIGH SQUEEZES: ADDUCTOR STRENGTH

This subtle but effective move strengthens inner thighs while requiring sustained muscle engagement that's great for glucose uptake.

How to do it:

• Stand tall, holding support if needed, or lie down, if that is easier for you 
• Place a Pilates ball (or rolled towel/small pillow) between inner thighs
• Inhale to prepare
• Exhale as you squeeze the ball with inner thighs
• Hold the squeeze for 3-5 seconds
• Inhale to release slightly (don't drop the ball)
• Repeat 10-12 times

What you'll feel: Deep inner thigh work that also engages your pelvic floor.

No equipment? You can do this without a ball by simply imagining you're squeezing one—the mind-muscle connection still provides benefits. 

Pregnancy timing: This is safe on your back in early pregnancy, but as you progress into second and third trimesters, limit time on your back to just a few reps.

7. MODIFIED BRIDGE: GLUTE AND CORE STRENGTHENING

This is one of the most effective exercises for building strength, plus it helps with the lower back discomfort common in pregnancy.

How to do it:

• Lie on your back with knees bent, feet hip-width apart
• Arms by your sides, palms down
• Inhale to prepare
• Exhale as you lift hips off mat, creating a straight line from shoulders to knees
• Squeeze glutes at the top
• Inhale at the top
• Exhale as you slowly lower, vertebra by vertebra
• Repeat 8-10 times

Blood sugar magic: Glutes are large muscles that are very efficient at using glucose for energy.

Pregnancy timing: This is safe on your back in early pregnancy, but as you progress into second and third trimesters, limit time on your back to just a few reps, or skip this move entirely and substitute with the modified cat-cow instead.

8. RELAXATION AND BREATHING: RECOVERY AND INTEGRATION

Never skip this final piece—it's where your nervous system integrates the work you've done and where stress reduction benefits kick in for blood sugar management.

How to do it:

• Find a comfortable seated position or lie on your left side with pillow support
• Close your eyes
• Inhale deeply for 4 counts
• Exhale slowly for 6 counts
• Visualize your breath nourishing both you and baby
• Stay here for 3-5 minutes

Why this matters: The extended exhale activates your parasympathetic nervous system, which helps your body manage glucose more effectively while reducing stress hormones that can interfere with blood sugar control.

For more on the connection between gentle movement and stress reduction for blood sugar management, see our blog post, 4 Gentle Yoga Poses To Try When You Have Gestational Diabetes (Safe for Every Trimester).

Putting It All Together

This complete routine takes about 15-20 minutes and can be done 2-3 times per week with rest days in between—exactly what's recommended for strength training during pregnancy with gestational diabetes.

Best timing: Try this routine in the morning to help with fasting blood sugar, or about an hour after a meal to help manage post-meal glucose levels.

Progression: Start with 5-8 reps of each move and build up to 10-12 as you feel stronger. The goal isn't to exhaust yourself—it's to challenge your muscles enough that they're actively using glucose.

When to Modify or Stop

Listen to your body above all else. Stop immediately if you experience:

• Dizziness or lightheadedness
• Shortness of breath beyond normal exercise exertion
• Any pain (discomfort from work is okay, sharp pain is not)
• Bleeding or fluid leakage
• Contractions

Always consult your healthcare provider before starting any exercise routine during pregnancy, especially when managing gestational diabetes.

Making It Sustainable

The most effective exercise program is one you actually do consistently. Here's how to make this routine stick:

Start small: Even 10 minutes of these moves is beneficial. Don't feel like you need to do the full routine every time.

Pair it with another habit: Do it after breakfast, or while watching your favorite show, or right before your evening blood sugar check.

Track your blood sugar response: Note how you feel and what your readings are on days you do Pilates versus days you don't. Seeing the positive impact can be motivating.

The goal isn't perfection—it's giving your body gentle, consistent movement that helps it do the complex work of managing blood sugar while growing a baby. These Pilates moves offer exactly that: strength without strain, challenge without exhaustion, and blood sugar benefits without overwhelm.

Where Can I Get More Support?

GD Kitchen! I created this resource to solve a problem I wish someone had already solved before my first GD pregnancy. I teamed up with OB Rachael Sullivan, DO and nutritionist Jamie Askey, RN, so that you'll have all the resources, and all the confidence, I didn't have myself.  

Looking for more? Check out the Blog, or try six free recipes here.

What else do we offer? The GD Starter Pack and The Recipe Membership.