Insulin

Women who have hyperglycaemia in pregnancy (including gestational diabetes) who require insulin must have their dosage reviewed and modified regularly (often weekly) during pregnancy.

Ideally, pregnant women should be managed with a multiple daily injection (basal–bolus) insulin regimen to allow flexible, tailored dosing. Preprandial bolus insulin doses may be required before one, two or all meals each day; rapid-acting insulin is preferred. Basal insulin is usually required at night; it may occasionally also be required before breakfast or lunch.

For women who are reluctant or unable to use a multiple daily injection (basal–bolus) insulin regimen, a mixed insulin regimen using fixed-dose combination (biphasic premixed) insulin two or three times daily may be appropriate. However, it is more likely to cause both hyperglycaemia and hypoglycaemia.

Seek specialist advice for insulin dosages.