By Dr. Gina Charles, D.O.

Imagine going through the beginning stages of pregnancy, overcoming morning sickness, changes in your breasts size, along with other major changes in your body. Just when you thought you were adjusting to your new normal, suddenly, at 24 to 28 weeks a routine test revealed that you have gestational diabetes. When it happened to me during my first pregnancy, my first thought was, "Wow, really? What’s next?"  

As a family physician, I treat all types of diabetes, and even I was surprised when I heard my diagnosis of gestational diabetes. Gestational diabetes is a temporary glucose intolerance that develops during the second or third trimester. It occurs due to hormonal changes, which block the action of the mother’s insulin to her body leading to an insulin resistance. In this case, her blood retains the glucose, causing high blood glucose levels.      

Gestational diabetes is diagnosed in 6 to 9% of pregnant women each year in the U.S. This condition has increased in recent years and is most prevalent in Asian and Hispanic women. Additionally, it is becoming an increasingly common diagnosis for expectant Black mothers. Genetics, race, and ethnicity aside, one’s environment and lifestyle: obesity status, diet etc. play major roles in developing this condition as well.  

Pregnant women who are diagnosed with gestational diabetes have an increased risk of carrying larger babies and, as a result, giving birth via cesarean section. Also, these expectant mothers are at increased risk for developing high blood pressure, preeclampsia, eye, kidney, and nerve problems, and have a higher chance of developing gestational diabetes in subsequent pregnancies.  Similarly, risks of gestational diabetes for babies include traumatic birth (in larger babies), premature status, jaundice, obesity, and future metabolic disorders. These particular babies, as well as their mothers, have an increased likelihood of developing type 2 diabetes in the future. 

As daunting as this all sounds, being diagnosed with gestational diabetes is not a cause for panic. Instead, it should be viewed as an opportunity to learn how to manage the changes in your body in pursuit of having a healthy pregnancy. Once diagnosed, it is important to follow a healthy eating plan created by your Ob/Gyn, nutritionist, or diabetic educator. Additionally, you should monitor your blood sugar levels, and exercise daily. In some cases, your Ob/Gyn may prescribe medication and it is important to adhere to that. 

With the help of a nutritionist, my Ob/Gyn, and my knowledge of gestational diabetes, we developed a personalized meal plan specific to my lifestyle. One of the major changes I made was monitoring my carbohydrate intake, as carbohydrates can raise blood sugar levels.  

Here is a sample of a gestational diabetic meal plan:  

Breakfast: 2 slices of toast, 1 scrambled egg, tea 

Snack: 8 oz low fat yogurt (be sure to check the sugar content of your yogurt to ensure it has less than 8 sugars total)

Lunch: chicken salad wrap, carrot sticks, 8 oz low fat milk or water

Snack: 23 almonds

Dinner: 1 cup of vegetarian chili (made with beans, corn, chickpeas), 1 piece of cornbread

Snack:  2 cups of popcorn 

These sample meals can be altered to fit your dietary preference.

The goal is to maintain blood sugars in an acceptable range. Furthermore, to achieve these goals:

1. Avoid white sugar, brown sugar, honey, molasses, and high fructose syrups

2. Limit candy and dessert intake

3. Do not drink soda, fruit juice, or sweetened juices

4. Eat 3 meals and 3 snacks per day, spacing them out per your nutritionist recommendation 

5. Control your carbohydrate intake as directed 

6. Do not skip meals, especially if you’re on insulin

7. Limit your caffeine intake  

After giving birth, your blood glucose levels will likely normalize, and the gestational diabetes will go away. It is important to follow up with your doctor 4 to 12 weeks postpartum to get tested for type 2 diabetes. If your results are negative for diabetes at that time, it is recommended that you test every 1 to 3 years to ensure that it hasn't developed later on.  

A study from a team of researchers at Kaiser Permanente demonstrated that Black women who experienced gestational diabetes were 52% more likely to develop type 2 diabetes later in life in comparison to Caucasian women. This is why periodic monitoring of blood glucose levels, a few months to a few years postpartum, is important. During the postpartum period, and onward, the goal is to maintain a healthy lifestyle by eating healthier foods and exercising regularly, thereby reducing your risk of overt diabetes in the future. Although my experience was initially nerve wrecking, it allowed me to develop better eating habits. I was able to use much of the things I learned to maintain a healthier lifestyle.  Sometimes, pregnancy does not go as planned but remember, you have your doctor to help you along the way. 

Dr. Gina Charles (Dr. G) is a board certified Family Medicine Physician and Entrepreneur who has been recognized by the American College of Osteopathic Physicians as one of their women physician leaders. Besides treating certain ailments affecting women, Dr. G found herself on the other side as a patient, when she experienced complications during her first pregnancy. Based on her experience and medical knowledge, Dr. G is committed to being an advocate for addressing maternal health disparities particularly for Black women. Her aim isn’t just to explore causes but to identify tangible solutions and empower Black mothers. She accomplishes this by encouraging women to use proper tools to live healthier lives, advocate for themselves, recognize when it’s time for them to seek extra help, and to understand that they aren’t alone. You can keep up with Dr. G’s work on her site, and follow her on Instagram @DrGinaCharles.