The weight-inclusive approach to
Gestational Diabetes Management
steps to a
successful
12
initial meeting
By McKenzie Caldwell, MPH, RDN
Looking for
handouts to use
with clients?
Check out these resources for weight-
inclusive prenatal nutrition counseling:
Gestational Diabetes Client Education
Intuitive Pregnancy Grocery Guide
© 2021 Feed Your Zest Nutrition & Wellness, LLC
1. Know that this client likely has received weight shaming messages
from other clinicians no matter what size their body is. They may
expect the same from you – be prepared with compassion.
2. Ask the client what concerns and questions they have; address
these as you move through the session.
3. Encourage the client that this is not their fault! Virtually every
pregnant person has at least 1 risk factor for developing gestational
diabetes.
4. Check for signs of an eating disorder – people with bulimia, OSFED,
or binge eating disorder may be more likely to develop gestational
diabetes. Regardless, the client’s current relationship with food
should inform your work.
5. Emphasize that you will not be micromanaging their weight, and
will simply check in for signs of malnutrition.
6. Educate the client on why weight gain is important during
pregnancy regardless of pre-pregnancy weight.
© 2021 Feed Your Zest Nutrition & Wellness, LLC
7. Explain the importance of checking blood glucose, how to do so
properly and less painfully, and where to record their levels.
Facilitate an air of non-judgment around blood glucose levels.
8. Review what foods affect blood glucose, and the importance of
including carbohydrates for normal daily function and fetal
growth. Provide initial guidance on carbohydrate pairing, as well as
on meal and snack timing.
9. Allow space for the client’s cultural foods and daily comforts to
have a place – discuss the restrict-binge cycle with the client and
let them know you will help them find ways to incorporate these
foods into their new routine in your follow-up sessions.
10. Introduce insulin or other medication as an additional option,
explaining the risks and benefits of focusing first on gentle
nutrition and movement to manage blood glucose during
pregnancy.
11. Set goals to begin tracking fasting blood glucose daily, and
postprandial blood glucose at other times you and the client
decide together are both important and feasible. Have the client
write down other SMART goals you discuss in session.
12. Close the session by expressing your concern about both mental
and physical health during pregnancy, emphasizing your role as a
support person during this stressful time, and providing a hard
copy of educational material like the Feed Your Zest Gestational
Diabetes Client Resource.
© 2021 Feed Your Zest Nutrition & Wellness, LLC
