The mother’s insulin requirements tend to be very low for the first few days after the baby is born and then gradually increases. However, if you had Celestone injections before the birth, your insulin requirements will probably fall less.
If you have type-1 diabetes, expect your insulin needs to change dramatically through the course of your pregnancy. The proportion of basal (background) to bolus (mealtime) insulin does not change much, but the total amount of insulin required goes through a complete metamorphosis.
Women with preexisting diabetes typically experience an increased need for insulin during the later stages of pregnancy due to an increase in insulin resistance during this time. A drop in insulin need late in pregnancy is often associated with placental complications.
However, insulin glargine U-100 has two suggested options for dosing adjustments in nonpregnant patients: either by 1 unit every day or by 2 units every 3 days (29). Insulin glargine U-300 and insulin degludec should only be adjusted every 3–4 days, and there is no recommendation regarding the number of units for each adjustment (25,26).
The mother’s insulin requirements tend to be very low for the first few days after the baby is born and then gradually increases.
Your endocrinologist or credentialled diabetes educator will help you re-adjust your insulin doses after birth. In the later stages of pregnancy or before you go home from hospital, discuss with your diabetes health professionals the best way of contacting them.
Insulin requirements tend to continue to rise until about 34 to 36 weeks, when they may plateau or start to fall a little. If you notice your insulin requirements fall significantly and rapidly in late pregnancy, promptly contact your diabetes in pregnancy team for advice.
For around the first six to eight weeks of pregnancy your blood glucose levels may be more unstable.
Mid to late pregnancy changes. From the second trimester of pregnancy, especially after 18 weeks your insulin requirements will usually start to rise. By around 30 weeks you may need up to two or three times as much insulin as you did before pregnancy.
Insulin changes during pregnancy, for women with type 1 diabetes. Insulin requirements tend to change constantly throughout pregnancy as different hormones take effect and your baby grows. You need to be prepared to adjust your insulin doses on a regular basis.
However, if you had Celestone injections before the birth, your insulin requirements will probably fall less. Your target blood glucose levels should be reviewed after the birth, and frequent blood glucose monitoring is recommended. Target blood glucose targets will be higher than your pregnancy targets.
Pregnancy requires that your body produce extra amounts of insulin. Insulin is a hormone that is made by the pancreas.
When your blood glucose levels stay raised despite meal planning and physical activity, insulin must be added to your management plan to keep you and your baby healthy. Pregnancy requires that your body produce extra amounts of insulin. Insulin is a hormone that is made by the pancreas. If your pancreas does not make enough insulin, injections can help you meet the need. Your health care provider and diabetes educator will teach you how to inject insulin safely and comfortably. Determining the right insulin and dosage Tip Keep a record of the type and amount of insulin you take. It is important that you know and remember your insulin type every time you speak with a health care provider. Your health care provider will decide what kind of insulin is right for you, how much to use and when you should take it, based on: your weight (which changes weekly) how far along your pregnancy is your meal plan your most recent blood glucose levels Sometimes, you may need more than one type of insulin. Different types of insulin work at different speeds, and your health care provider may combine insulins to achieve the best results for you. Time-action of different insulins Insulins Starts working Peaks Stops working Rapid acting: Humalog® (lispro) NovoLog® (aspart) Apidra® (glulisine) 5 to 15 minutes 1 to 2 hours 2 to 4 hours Intermediate acting: NPH (N) 2 to 4 hours 4 to 8 hours 10 to 16 hours Basal*: Lantus® (glargine) Levemir® (detemir) 2 hours No peak 24 hours *Lantus® and Levemir® cannot be mixed with any other insulin. How to help insulin work best Take your insulin at the same times each day as directed. Talk with your health care provider if you feel sick. Follow any instructions your health care provider gives you. Don't change your meal plan, physical activity, pres Continue reading >>
Great Expectations A healthy pregnancy with diabetes is a challenge, but consider this: Less than 100 years ago, before the discovery of insulin, many young women with Type 1 diabetes didn’t even live to reach childbearing age. And less than 30 years ago, physicians routinely told young women with Type 1 diabetes that pregnancy was far too dangerous for both mother and child. Today, thanks to advances in diabetes treatment, plus improvements in medical care for infants, there has never been a better time for you to have a healthy baby. Insulin pump therapy is one of the options available to women today for managing diabetes during pregnancy. Challenges of pregnancy Pregnancy with diabetes presents a variety of challenges for you and your diabetes management team far beyond the routine morning sickness, fatigue, and strange food cravings experienced by many women who are expecting. The length of time you’ve had diabetes as well as the course of your disease influences the seriousness of medical risks during your pregnancy. For example, if you have mild retinopathy, it may progress during pregnancy. Your kidney status could worsen. Women with diabetes are at higher risk for frequent and severe hypoglycemia (low blood glucose) during pregnancy because glucose crosses the placenta to provide nutrition for the growing baby. The pregnancy state also tends to allow diabetic ketoacidosis — a dangerous condition usually accompanied by very high blood glucose — to develop quickly. Having a thorough medical evaluation prior to pregnancy is extremely important for determining your individual situation and management solutions. Good blood glucose control before and during pregnancy will minimize all risks to the mother. Risks to the baby are also a consideration when a woman Continue reading >>