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    Gestational Diabetes Foods and Management: An Eye-Opening Interview with Dr. Kenneth K. Chen

    Updated 15 November 2021 |
    Published 18 March 2020
    Fact Checked
    Medically reviewed by Dr. Kenneth Chen, Director of the division of obstetric and consultative medicine, Women & Infants Hospital, Rhode Island, US
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    Unlike preexisting diabetes, gestational diabetes is diagnosed for the first time during pregnancy. Gestational diabetes causes high blood sugar and can affect your pregnancy. In this interview, Dr. Kenneth K. Chen speaks about managing gestational diabetes with diet and exercise tips.

    Interview has been edited for clarity.

    How to manage gestational diabetes

    “In all countries, pregnant people are routinely screened for gestational diabetes, and once they get a positive test, we encourage all of them to go on a special diet,” says Dr. Chen. 

    Here’s what health care providers usually ask people to do once they get a positive diabetes test: 

    • Meet with a nutritionist to discuss changes they need to make to their existing diet. 
    • Test their blood glucose levels on a regular basis. 

      “We typically get them to test four times a day: early in the morning after fasting and then three times after each main meal (breakfast, lunch, and dinner). 

      “The postprandial tests are usually done two hours after each main meal, but in some countries, the standard of care is to test one hour after each main meal,” says Dr. Chen.

    Dr. Chen says that health care providers educate people with gestational diabetes on what their target levels should be.

    Insulin is considered the gold standard of treatment, but in some instances, oral hypoglycemic agents such as metformin and/or glyburide can also be considered.

    “In the U.S., fasting glucose levels should be below 95 mg/dL, and two-hour postprandial glucose levels should be below 120 mg/dL. If these numbers are continually being exceeded despite being on a low-glycemic diet, then the pregnant person will need to be started on insulin therapy as well. 

    “Insulin is considered the gold standard of treatment, but in some instances, oral hypoglycemic agents such as metformin and/or glyburide can also be considered,” Dr. Chen advises.

    Food for gestational diabetes

    Dr. Chen shares some basic dietary concepts that he personally discusses with pregnant people.

    First of all, he finds out what types of drinks they consume on a regular basis. Nearly 40 to 50 percent of all sugar intake comes from beverages on a daily basis. 

    “If they only drink water, then we quickly move on to the foods that they eat. But if they are 

    drinking a lot of soda and fruit juices, the first thing I tell them is to reduce their consumption significantly, as this is a very quick and easy way to improve their glucose levels,” says Dr. Chen. 

    In terms of food, Dr. Chen discusses the broad concepts of glycemic load and glycemic index with his patients.

    Glycemic load

    Dr. Chen counsels people on how to estimate the glycemic load of their meals, and educates them on the importance of maintaining a balanced diet throughout pregnancy, as they need to eat a good amount of carbohydrates for fetal well-being. 

    “As an example, I tell them to eat roughly 30 grams of carbohydrates per main meal and about 15 grams of carbohydrates for each snack. I tell them to try not to exceed this amount for one particular meal, because if they do that, then it is quite likely that this will cause their glucose levels to rise,