Pregnancy Insulin Therapy

Submitted by Thiruvelan on Sun, 04/21/2013
Pregnancy Insulin Therapy

Learn insulin therapy during pregnancy - insulin analogue, insulin pump, insulin dose calculation and safe administration of insulin.

Diabetes pregnancy insulin therapy

Insulin therapy during pregnancy is considering to be safer and effective in diabetes management with proper blood-glucose control. Insulin treatment has no known side effects and considering as harmless during pregnancy.

What insulin analogue is safe during pregnancy?

The rapid-acting insulin analog (such as Humalog or lispro, Novolog or aspart, Apidra or glulisine) as bolus insulin has been promising results in lowering hyperglycemia during pregnancy, with a lower incidence of neonatal complications. NPH insulin is the only basal insulin that has adequately studied in pregnancy. The long-acting insulin analogs do not yet sufficiently study to warrant their use during pregnancy.

During pregnancy, is it a good idea to use an insulin pump?

Surely, insulin pump is the best choice of treatment for diabetes, however; you need some time to well verse with it. During this period, you may have risk of getting diabetic ketoacidosis (DKA) or hypo. Which can be fatal for your fetus, thus it is not a good choice to start an insulin pump in the middle of pregnancy. If you are planning pregnancy, you can change to insulin pump and get enough experience can help you attain the best blood-glucose control.

How do I calculate my insulin dose during pregnancy?

Begin with you need to calculate your total daily insulin dose requirement. You can derive this by multiplying your body weight in kilograms with a constant “k," this k will be 0.7, 0.8, and 0.9 for first, second, and third trimesters respectively.

Total insulin requirement = weight in kilograms x “k “where k = 0.7, 0.8, and 0.9 for first, second, and third trimesters, respectively.

The 50 % of this total insulin requirement is given as basal insulin daily dose provides by the long-acting insulin. You should administer this before breakfast, before supper, and at midnight.

The remaining 50% of the total insulin requirement is given as a bolus insulin dose provides by the rapid-acting insulin. You should administer before breakfast, before lunch, and before supper.

Does the insulin will go into my baby?

Insulin treatment during pregnancy is always beneficial to both mother and the fetus, because it helps to maintain near a normal blood-glucose level. Insulin you are taking is utilizing by your body and will not cross placenta, thus no harm to your baby. However, untreated hyperglycemia can harm the baby.

Do babies make their own insulin & a mother get it from their baby?

Fetus starts making insulin from 10th gestational week. Either mothers or fetus insulin does not crosses the placenta, however mothers blood glucose cross placenta. That is why your doctor insists for stringent insulin treatment to maintain good health of you and your baby.

Does insulin injection on my stomach, increases post-delivery stretch marks?

No. Stretch marks develop due to scarring that occurs when the skin expands a lot, such as during pregnancy or remarkable weight gain or weight loss. Stretch mark cannot increase or decrease due to insulin shots in the abdominal area. Insulin shots in the legs are more painful compared to stomach.

Even if you had stretch marks from your previous pregnancy, you can give your insulin shots through stretch marks. Always rotate your injection site; otherwise, you will end up with sunken spots.

Does the abdominal insulin-shot can hurt baby?

It is unlikely that a needle will ever hit the baby and cause a problem. However, it becomes harder during pregnancy to inject into the fat just below the skin.

In early pregnancy, you can be able to pinch up the skin in the abdomen as you normally do. However, in late pregnancy, the skin over the stomach is very tight with little fat below the skin. If you are able to pinch up the skin, you can continue injecting in the stomach. If you cannot pinch up, change your site somewhere in the sides of your stomach that has enough fat. This is only for those who are using needles more than 5 mm length, if you are using insulin pen or 5 mm syringe, then you may not need to pinch up your skin.