Background: Gestational diabetes mellitus (GDM) is one of the commonest medi-cal complications of pregnancy and carries short- and long-term risks for mother and child. Standard care rests on
Background: Gestational diabetes mellitus (GDM) is one of the commonest medical complications of pregnancy and carries short- and long-term risks for mother and child. Standard care rests on screening, medical nutrition therapy, physical activity, glucose monitoring and, when needed, insulin or metformin. Interest in Ayurvedic approaches is growing in India, but GDM is not described as a discrete entity in the classical texts and Ayurvedic clinical data are very limited. Objective: To present a conceptual Ayurvedic understanding of GDM, to examine which dietary and lifestyle principles of Garbhini paricharya are compatible with current evidence, and to assess critically the evidence and safety concerns for herbal interventions in pregnancy. Methods: Classical texts (Charaka Samhita, Sushruta Samhita, Kashyapa Samhita) were reviewed for antenatal regimen and Prameha. PubMed was searched for guidelines, reviews, meta-analyses, trials and experimental studies on GDM, nutrition, herbal medicine, Ayurveda and safety in pregnancy. Findings were synthesised narratively. Results: GDM can be interpreted heuristically as a pregnancy-specific disturbance of Agni and Kapha-Meda metabolism, with features overlapping Prameha, but this correlation is a modern construct. Randomised evidence supports individualised medical nutrition therapy favouring lower-glycaemic-index, fibre-rich carbohydrate, and some evidence supports myo-inositol for prevention, although certainty is generally low. No randomised trial of an Ayurvedic herb or formulation in women with GDM was identified; the only Ayurveda-specific GDM data were a decision-support modelling study and an animal study of Tinospora cordifolia. Safety data in pregnancy are lacking for most antidiabetic herbs, and contamination of some Ayurvedic products with heavy metals is a documented risk. Conclusion: Ayurvedic dietary and lifestyle principles may complement, but must not replace, standard GDM care. Herbal antidiabetic agents should not be used in pregnancy outside well-designed, ethically approved trials.