Department of Obstetrics and Gynecology
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TAKING DIABETES MEDICINE DURING PREGNANCY

PILLS

Using pills may be one way you can control your blood sugar levels. You may know people who take pills to keep blood sugar levels normal. There are a couple of pills that we may be able to give you to help you control your blood sugars.

INSULIN

Using insulin may be the only way to keep your blood sugar normal while you are pregnant. If you need insulin, you will learn how to give yourself shots. Another form of insulin delivery is an insulin pump.

SOME THINGS TO REMEMBER

  • There are different brands of insulin.
  • There are different types of insulin. Some work fast, and some work slow. You may take one kind or both.
  • HumaLog and NovoLog are rapid-acting. These insulins begin to work 5-15 minutes and last about 4 hours. HumaLog or NovoLog are clear insulins.
  • NPH insulin works more slowly. This insulin starts working in about 4 hours and lasts 12-24 hours. NPH is milky or cloudy insulin.
  • As you get further along in your pregnancy, you will need more insulin.
  • Always measure your own insulin. Do not let friends or family measure the insulin for you.
  • When you open a new bottle of insulin, check the side of the bottle for the expiration date to make sure the insulin is still good. Write the date on the side of the bottle and discard the bottle after 30 days.
  • Store the extra unopened bottles of insulin in the refrigerator.

 

 

 

 

 

 

 

HOW DO I MEASURE TWO KINDS OF INSULIN?

When you take two kinds of insulin at the same time you can mix them together in one syringe. To mix the Humalog or NovoLog and NPH insulin together, follow these steps:

Go to fullsize image

Wash your hands with warm soap and water.
Roll the NPH (cloudy) insulin bottle between the palms of your hands to mix the insulin and least 30 times with the bottle laying on it's side. Do not shake bottle of insulin.
Clean the top of both bottles with alcohol.
Pull back on the plunger until you have the amount of air that is the same as your dose of NPH insulin.
Take off the needle cap. Put the needle into the NPH insulin bottle and push the air in. Take out the needle.
Pull back on the plunger until you have the amount of air that is the same as your HumaLog or NovoLog (clear) insulin dose.
Put the needle into the HumaLog or NovoLog insulin bottle and push the air into the bottle. Leave the needle in, turn the bottle upside down and pull back slowly on the end of the plunger to get the right dose of insulin.
Take the needle out of the (clear) insulin bottle.
Now put the needle through the rubber top of the NPH (cloudy) insulin. Turn the bottle upside down and pull out the NPH insulin. Remember, you already added air.
To get the right amount of insulin you need to add up the amount of NPH and HumaLog or NovoLog. When you are finished you should have that many units of insulin in the syringe.
If you make a mistake when you are pulling out the NPH, do not push the insulin back into the bottle. This will mix the insulins together in the bottle. Instead, throw away that syringes and start over.

 

 

 

 

 

 

 

 

 

HOW DO I GIVE MYSELF A SHOT?

Giving a shot can be scary. Most people are afraid that they will not be able to give the shot right or that the shot will hurt. The insulin syringes that you will use have very tiny needles. Many people say that the shots do not hurt, but that they get tired of giving themselves shots.

SOME THINGS TO REMEMBER

Your insulin shots need to become part of your daily life. Carry your supplies with you if you are going out around meal time.
Give your shot 5-15 minutes before you eat before you eat.
Most pregnant women take a shot before breakfast, before dinner and at bedtime. Your healthcare provider will tell you if you should take insulin differently. As your baby grows you will need more insulin. Your healthcare provider may change the amount of insulin you need every 4 to 7 days. This is normal and does not mean you are doing anything wrong.
Even if you are taking insulin, you still need to follow your meal plan and exercise to keep your blood sugar as close to normal as possible

 

Go to fullsize image Pick the spot on your stomach for your shot and wash the site with soap and water. Do not use alcohol to prepare the site.
Use a new U-100 insulin syringe every time.
Pull the skin flat or pinch it up with one hand.
Hold the syringe in your other hand like a pencil or dart.
Put the needle straight into your skin all the way.
Push the end of the plunger all the way down so that all of the insulin goes into the site.
Pull the needle out and press on the skin with a Kleenex or cotton ball.
Throw your used needles into a laundry or bleach bottle with a lid. Do not throw them into the garbage or keep them where anyone could get stuck by them.
Give your shot in a different place on your belly each time at least 2 inches from your last spot and 2 inches away from your naval area. If you use the same spot, the spot will get hard and all of the insulin will not be able to get into your body.
Some people bleed a little or get black and blue where they give their shots. If you have any problems with your shots, please call a member of your healthcare team.

 

 

 

 

 

 

 

 

 

ARE THERE TIMES WHEN I NEED EXTRA INSULIN?

Most pregnant women with diabetes will take three shots of insulin a day:

AM-a mix of NPH and HumaLog or NovoLog
Dinner-HumaLog or NovoLog
Bedtime-NP

Go to fullsize image There are times when the usual amount of insulin is not enough. You may need to take extra insulin sometimes and even extra shots.
If you are checking your blood sugar before you eat and the sugar is higher than 100, your doctor or diabetes nurse specialist may ask you to take extra insulin. If you blood sugar is higher than 100 before your bedtime snack before you go to bed, you will need extra insulin.

 

 

 

 

SOME THINGS TO REMEMBER

Extra clear insulin is always HumaLog or NovoLog (rapid acting)
If it is time when you usually take insulin, you would add the extra HumaLog or NovoLog to your usual dose.

If it a time when you do not usually take insulin, you would take the extra HumaLog or NovoLog alone.
You will need to eat 5-15 minutes after you give yourself your shot.

ALWAYS keep all of diabetes supplies out of the reach of children.

 

Always consult your personal physician about your plan of care. The above information is for educational purposes only and is not to be used for individual treatment or diabetes self-management recommendations.