Insulin treatment in pregnancy

Abstract

Due to the teratogenic potential of many oral hypoglycemic agents, insulin injections are the primary treatment for diabetes in pregnant women. There has been insufficient study of insulin glargine in pregnancy. Therefore, NPH insulin continues to be the primary basal insulin used in pregnancies. The insulin requirement rises substantially in the second and third trimesters. NPH insulin and rapid-acting insulin are mixed typically in a 1:1 ratio and administered at each main meal. The insulin pump is a viable alternative to multiple injections. During labor, insulin requirements decrease sharply, and in the postpartum period return to the levels of the non-pregnant state. Drug Dev Res 69: 119-123, 2008.