Fasting during Ramadan is one of the five pillars of Islam. Ramadan is a month long fast - where no food or drink is consumed from sunrise to sunset. This fast includes oral medication. Whilst pregnancy and medical illness exempts a Muslim person from fasting, many still desire to do so. The diet followed during Ramadan often includes a high intake of calories, carbohydrate and sugar at the meal taken to break the fast at sunset (iftar). Multiple snacks may follow this meal. A second main meal (suhoor) is then eaten before sunrise. This presentation will provide an overview of the potential risks and current evidence regarding the implications of Ramadan fasting for a woman with GDM. An overview will also be provided on existing practical clinical guidelines including advice on blood glucose testing times and Medical Nutrition Therapy (MNT). MNT during Ramadan fasting needs to ensure that the woman with GDM eats a balanced diet, and an adequate amount of calories for pregnancy. At the same time, carbohydrate intake should be spread evenly over meals and snacks to minimise post prandial hyperglycaemia. MNT needs to be individualised, taking into account the patient’s comorbidities, nutritional requirements, lifestyle and cultural food preferences.