When the OGTT is abnormal – what next?                                   OGTT is Oral Glucose Tolerence Test

A diagnosis of hyperglycemia in pregnancy (gestational diabetes mellitus or overt diabetes) does not mean you need to stop eating carbohydrates. The goal is to control blood sugar while ensuring adequate nutrition for your baby.

Step 1:

 Meet a Dietitian

A dietitian can prepare an individualized meal plan based on your:

Pre-pregnancy BMI

Current weight gain

Physical activity

Food preferences

Blood sugar values

Step 2: 

Follow Medical Nutritional Therapy

1. Eat 3 small meals and 2–3 healthy snacks daily

Avoid long gaps between meals.

Include a bedtime snack to reduce overnight fasting.

2. Choose complex carbohydrates

Whole wheat chapati

Brown rice

Millets (jowar, bajra, ragi)

Oats

Quinoa

Avoid:

Sugar

Sweets

Cakes, pastries

Sweetened beverages

Fruit juices

3. Include protein with every meal

Good choices:

Milk or curd (unsweetened)

Paneer

Eggs

Pulses and dals

Sprouts

Soy products

Fish or chicken (if non-vegetarian)

4. Eat plenty of fibre

Green leafy vegetables

Salads

Cucumber

Tomatoes

Carrots

Beans

Cauliflower

Aim for at least half your plate to be vegetables.

5. Fruits

1 small serving at a time.

Prefer whole fruits.

Avoid fruit juices.

Limit very sweet fruits such as mangoes, grapes and chikoo.

Step 3: 

Stay Active

Unless advised otherwise by your obstetrician:

Walk for 20–30 minutes after meals, especially after lunch or dinner.

Aim for at least 150 minutes of moderate activity per week.

Step 4:

Monitor Blood Sugar

Check blood glucose as advised.

Common targets are:

Fasting: <95 mg/dL

1-hour after meals: <140 mg/dL

2-hour after meals: <120 mg/dL

Step 5:

Review After 1–2 Weeks

If blood sugar remains above target despite following MNT and exercise:

Your doctor may recommend insulin, which is the preferred treatment during pregnancy.

In selected cases and depending on local guidelines, oral medicines such as Metformin may be considered, but insulin remains the standard when diet alone is insufficient.

Sample Plate Method