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Insulin During Pregnancy

Insulin During Pregnancy And Breastfeeding

Insulin During Pregnancy And Breastfeeding

Generic Name: Insulin Indications: Treatment of diabetes FDA Drug Category: B Summary Recommendations: Insulin is commonly given to patients to treat diabetes in order to lower blood sugar glucose. Controlling diabetes during pregnancy and lowering blood glucose sugar can reduce the risk of pregnancy complications and increased fetal weight. Your insulin dose may change during pregnancy. You should always keep prenatal appointments and track blood glucose levels daily. General Precautions: Diabetes can be a dangerous health condition during pregnancy. You should always maintain diabetes care and good blood sugar control during pregnancy and after birth. Diabetes care can be extremely specialized so your obstetrician will likely leave care to your primary care physician for medication and alternative treatment options. Various types of insulin exist, including short-acting, intermediate-acting, long-acting and fast-acting. Effect While Trying to Conceive: While insulin is not directly associated with infertility, diabetes, especially when it is uncontrolled can affect fertility in both men and women.Treating diabetes and lowering blood sugar glucose may improve fertility. If diabetes is found during medical testing, insulin treatment may help resolve the hormone imbalance, leading to more balanced fertility hormones and improved fertility. Effects on Pregnancy: Insulin is the drug of choice for treatment of diabetes during pregnancy. Insulin does not cross the placenta, and it does not go to the fetus. However, sugar glucose in the mother does cross the placenta and go to the fetus and can adversely affect the fetus. That is why taking insulin is important so the elevated sugar in the mother's blood does not adversely affect the feus. Doctors also use the drug to treat g Continue reading >>

Using Insulin In Pregnancy With Type 1/2 Diabetes

Using Insulin In Pregnancy With Type 1/2 Diabetes

Much of the business of managing your diabetes in pregnancy involves checking your blood glucose levels and adjusting your treatment regime accordingly. For some women with diabetes, the need to change treatment during pregnancy can be frustrating, especially if you have maintained good control and are settled into the treatment you were using. Learning to inject or use a pump can feel like just another thing to do. But try to stay positive. Focus on the fact that this technology is available to help you keep your glucose at safe levels for your baby. Each day that passes takes you one day closer to your baby being born. After your baby is born, your diabetes will probably return to its original patterns. 'I think it is one of the hardest things I have had to do, both times, but you just kind of keep going. It’s like running a marathon. You know that you will eventually get to the end, and it does seem really tough at the beginning but you just get through it.' Prisha, mum of two If you were already using insulin Your team may change your doses or suggest that you try a regimen that is more effective. You may be using a syringe, a pen or a pump. If you are new to insulin Insulin only works if it is injected – so if you need to take it, then this will mean injecting. If you need to start giving yourself insulin injections, your diabetes team will show you how to inject yourself, what times you need to do it, how to keep your insulin and where to put the used needles. Many people do not like the idea of injecting, but try not to worry – injecting insulin is not like injections you may have had in the past. You will be using either a syringe or a pen, with a very fine needle. These are not usually painful, though they may feel worse if you are anxious. Once people le Continue reading >>

Myth-busting Insulin For Gestational Diabetes

Myth-busting Insulin For Gestational Diabetes

Gestational diabetes is a roller coaster ride from start to finish. There is a lot of information to navigate and often at a session with your diabetes educator you don’t know what questions to ask. So we pulled together an extensive list of questions about insulin for gestational diabetes. We wanted to highlight the positives and to bust the myths. We hope that after reading this you’ll feel more informed and less anxious about insulin treatment. Written by Natasha Leader, Accredited Practising Dietitian & Credentialled Diabetes Educator Do many women with GDM have to take insulin? It tends to depend on your treatment centre and which timing and targets your health practitioners are using. For example you may be advised to check your blood glucose level at 1 hour or 2 hours after the meal. There may also be some variation in the target level of glucose that your doctor/diabetes educator uses i.e may be < 7.4 or 8.0 1hr or <6.7 or 7.0 for 2hr time point. The percentage of women who need insulin is usually between 20 and 60%. Have I failed if I end up having to take insulin? Absolutely not. The need for insulin is related to how much insulin your body is able to make and whether this is enough to process the amount of carbohydrate food you and baby need to stay well. In most cases it is not a reflection of the effort you are making with your diet. Is the insulin going to harm my baby in any way? Insulin will not harm your baby but high glucose levels may. Insulin is used because it only crosses the placenta in very small amounts (compared with oral agents) and therefore is considered the safest way to control your blood glucose levels if diet and exercise alone are not enough. Are there any long-term effects from taking insulin? No. Taking injected insulin is just in Continue reading >>

Taking Insulin During Pregnancy

Taking Insulin During Pregnancy

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 >>

Diabetes During Pregnancy

Diabetes During Pregnancy

What is diabetes? Diabetes is a condition in which the body can't make enough insulin, or can't use insulin normally. Insulin is a hormone. It helps sugar (glucose) in the blood get into cells of the body to be used as fuel. When glucose can’t enter the cells, it builds up in the blood. This is called high blood sugar (hyperglycemia). High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart. In early pregnancy, high blood sugar can lead to birth defects in a growing baby. There are 3 types of diabetes: Type 1 diabetes. Type 1 diabetes is an autoimmune disorder. The body's immune system damages the cells in the pancreas that make insulin. Type 2 diabetes. This is when the body can’t make enough insulin or use it normally. It’s not an autoimmune disease. Gestational diabetes. This is a condition in which the blood glucose level goes up and other diabetic symptoms appear during pregnancy in a woman who has not been diagnosed with diabetes before. It happens in about 3 in 100 to 9 in 100 pregnant women. What causes diabetes during pregnancy? Some women have diabetes before they get pregnant. This is called pregestational diabetes. Other women may get a type of diabetes that only happens in pregnancy. This is called gestational diabetes. Pregnancy can change how a woman's body uses glucose. This can make diabetes worse, or lead to gestational diabetes. During pregnancy, an organ called the placenta gives a growing baby nutrients and oxygen. The placenta also makes hormones. In late pregnancy, the hormones estrogen, cortisol, and human placental lactogen can block insulin. When insulin is blocked, it’s called insulin resistance. Glucose can't go into the body’s cells. The glucose stays in Continue reading >>

Insulin Pregnancy And Breastfeeding Warnings

Insulin Pregnancy And Breastfeeding Warnings

Insulin Pregnancy Warnings Insulin crosses the human placenta in small amounts. In one study, in which 28 cord-serum samples from pregnant women who were receiving animal insulin were evaluated, animal insulin constituted 27% of the total insulin measured from cord serum. The rate of congenital malformations appears to be associated with the severity of maternal diabetes rather than the use of insulin, a naturally-occurring hormone. The question of whether exogenous insulin itself or insulin-induced hypoglycemia causes the significantly elevated incidence of congenital malformations in infants of diabetic mothers has been evaluated. A significantly higher percentage of major malformations has been associated with elevated hemoglobin A1C levels, suggesting that hyperglycemia, or poor control of diabetes, and not insulin, is the causal factor. Diabetes portends risk during pregnancy. In a nationwide, four-year retrospective review of 491 insulin-dependent diabetic pregnancies in Sweden, the rates of pregnancy-induced hypertension or preeclampsia, premature delivery, Cesarean section, large-for-age offspring, and perinatal mortality in the diabetic group were more than four times higher than normal. Insufficient maternal insulin secretion or action may result in increased insulin secretion by the fetus, increased fetal growth and fat deposition, and neonatal hypoglycemia. Maternal diabetes mellitus may be complicated by fetal macrosomia, relatively large-for-age offspring, and predisposes the offspring to diabetes. Gestational age appears to be a determinant of neonatal morbidity. Many experts recommend delivery at 38 weeks, if possible. There is an impaired counterregulatory response to hypoglycemia in pregnant diabetic women. Relative to nonpregnant diabetic women or nor Continue reading >>

Has Anyone Refused Insulin For Gestational Diabetes?

Has Anyone Refused Insulin For Gestational Diabetes?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Has anyone refused insulin for gestational diabetes? After not having diabetes pre-pregnancy, I was diagnosed with gestational diabetes on Tuesday and tried to control by diet, but most of the readings in the two days I have tested blood glucose were higher than the NICE guidelines (over 7.7 mmol/l one hour after meals and over 5.8mmol/l before breakfast): Now considering that according to the NHS the normal type 2 diabetic acceptable readings are that "a normal blood glucose level is between 4.0-6.0 mmol/l before meals (preprandial), and less than 10.0 mmol/l two hours after meals (postprandial)": I am under the normal type 2 limits, but over the NICE guidelines. Also notice that the NICE guidelines say ONE hour after meals and the normal guidelines say TWO hours after meals. This seems grossly unfair and I have not been able to find any reason why the goalposts have been moved, either on the interenet or by asking people. The diabetic nurse couldn't answer the question either and said "but these are national guidelines" (for anyone who has seen the film This is Spinal Tap, she may as well have said "these go up to 11 I'm not doing anything "wrong" with my diet as I confirmed with the dietician today, so the diabetic nurse/midwife wanted me to go on insulin. I asked if they did tablets and they said no, only insulin. This to me seems very extreme. The nurse got out the insulin pen to show me, I saw the needle and completely freaked out. I burst into uncontrollable sobbing and my eyes glazed over when she asked me if I was going to try it in my stomach or my thigh. When I didn't respond, she offered to inject it into my stomach or thigh. I still wasn' Continue reading >>

Insulin During Pregnancy - Uses & Side Effects You Should Be Aware Of

Insulin During Pregnancy - Uses & Side Effects You Should Be Aware Of

Are you worried about your insulin levels during pregnancy? Have you heard of gestational diabetes? Well, if you are anxious and clueless reading this article may be a good idea. During pregnancy, your doctor may keep a tab on various health parameters including blood sugar levels. Has your doctor prescribed you insulin but you’re not sure about its safety, especially during your pregnancy? Fret not! The post will tell you about the insulin use during pregnancy and its effects. Read on to know all about it and keep your worries at bay. What Is Insulin? Insulin is a hormone that helps your body absorb glucose from the blood. Your liver and muscles store the glucose in the form of glycogen. It prevents your body from using up fat as a source of energy. When the amount of insulin in your blood is very less, your body cells are not able to use the stored glucose. In such a situation, your body starts using up the fat as a source of energy. Over time, the glucose keeps accumulating inside your body and your blood sugar levels may rise steadily. What Is Gestational Diabetes? When you are pregnant, your body goes through certain hormonal changes. It may cause gestational diabetes in many women. There are certain hormones in your placenta (1) that can cause insulin resistance (2), a condition that interferes with the way insulin regulates the glucose levels in your body. Your placenta will grow as the pregnancy progresses. As a result, it will produce more hormones and increase your insulin resistance. Am I At Risk Of Developing Gestational Diabetes? Here are some of the factors that may increase your risk of developing gestational diabetes (3). Do speak to your doctor about any other tests that you may need to undergo. If you were overweight before you became pregnant. If yo Continue reading >>

How To Manage Insulin During Pregnancy

How To Manage Insulin During Pregnancy

Pre-conception and 1st trimester Maintaining the best possible glucose control before and at the start of pregnancy can reduce the risk of complications for the baby. However, it is also a time of increased risk of hypoglycaemia for the mother, so insulin doses may drop later in the first trimester. 2nd trimester At this point, the placenta is fully developed and hormone levels begin to rise steadily, causing insulin requirements to increase as well. In particular the pre-meal boluses may have to be increased to keep tight glucose control after meals. 3rd trimester Because insulin is absorbed more slowly and can be less effective at lowering glucose in late pregnancy, you may need to give larger doses even earlier, up to 30 to 40 minutes before eating. Maintaining tight glucose control throughout the last trimester can help to enhance the baby’s final organ development, maintain a normal birth-weight and reduce the risk of hypoglycaemia for your newborn baby. Labour and delivery During delivery, glucose levels will be closely monitored to ensure they remain within the target range. Small boluses of insulin may be required, with many women opting to continue insulin pump therapy during delivery. Immediately after delivery and up to 24 hours post-delivery, insulin requirements can decrease significantly and blood glucose target levels may be changed. Back at home Adjusting to life with the new baby often means unpredictable sleeping and eating schedules, which can be a challenge when also managing diabetes. For nursing mothers glucose levels may drop quickly during and after feeding, making it important to check blood glucose levels regularly and reduce insulin doses when required. After a month of pump therapy my HbA1c dropped from 8.3% (67 mmol/L) to 6.2% (44 mmol/L) Continue reading >>

Insulin Use In Pregnancy: An Update

Insulin Use In Pregnancy: An Update

As of June 2015 in the United States, 2.7% of women who are 18–44 years of age have a diagnosis of type 1 or type 2 diabetes (1). About 5% of all diagnosed diabetes is type 1 diabetes, and 90–95% is type 2 diabetes. It is projected that, by 2050, one in three people will have some type of diabetes. An estimated 5,000 new cases of type 2 diabetes will be diagnosed annually in American children <20 years of age (2). Gestational diabetes mellitus (GDM) could affect up to 8.7% of all pregnancies in the United States (3). The Centers for Disease Control and Prevention reports that these numbers are still on the rise (2). As the age of diabetes diagnosis decreases in U.S. youth, the prevalence of pregestational diabetes is likely to increase in the pregnant population. Maternal diabetes causes complications in the embryo/fetus that start in the uterus, are present immediately after birth, and could potentially last a lifetime. Women with type 1 diabetes or type 2 diabetes diagnosed before or during the first trimester of pregnancy are at the greatest risk for fetal congenital anomalies and spontaneous abortions. This risk is associated with both frequent and severe hyperglycemia before conception and during organogenesis (5–8 weeks after the last menstrual period) (4,5). The more severe the maternal hyperglycemia, the greater is the risk for fetal abnormalities. Structural anomalies are a common result, with ∼37% of these affecting the cardiovascular system, 20% affecting the central nervous system, and 14% affecting the urogenital system (6). GDM develops and is diagnosed later in pregnancy, at 24–28 weeks’ gestation, when impaired glucose tolerance is detectable. Therefore, women with GDM are most likely euglycemic during organogenesis and have a decreased risk Continue reading >>

What Is The Best Insulin Type And Regimen For Pregnant Women With Pre-existing Diabetes?

What Is The Best Insulin Type And Regimen For Pregnant Women With Pre-existing Diabetes?

What is the issue? The insulin needs of pregnant women with type 1 or 2 diabetes change during pregnancy. Insulin is available in many forms, which affect how often and when the insulin is given. These forms vary in the time needed before the insulin has its effect, how long the effect may last, and whether it is made from animals or humans, which may be important personally or culturally. This review looked at the safest and most effective types and ways of giving insulin during pregnancy. Why is this important? Women with type 1 or 2 diabetes are at increased risk of complications during pregnancy and birth. They are more likely to experience pregnancy loss (stillbirth, miscarriage), high blood pressure and pre-eclampsia (high blood pressure associated with swelling and protein in the urine), and have large babies (called macrosomia, when the baby is 4 kg or more at birth) that result in injury to the mother or baby. The likelihood of having a caesarean is increased. Mothers and babies may have complications related to managing blood glucose levels. The baby is more likely to become overweight and develop type 2 diabetes. We wanted to find out the best type of insulin and regimen to use during pregnancy. What evidence did we find? We found five randomised trials (N = 554 women and 554 babies) in October 2016. Each trial looked at different insulin types and ways of giving the insulin. Different outcomes were looked at in each trial. One trial did not include any of the review's main outcomes. All five trials were small, and at a high or unclear risk of bias because of limitations in how the trials were conducted. The quality of the evidence was very low. When rapid-acting human insulin (Lispro) was compared to regular insulin (N = 33), investigators found no clear dif Continue reading >>

If You Need Insulin During Pregnancy

If You Need Insulin During Pregnancy

Your body may not be able to make enough insulin to keep your blood sugar under control during pregnancy. If this happens, you mayneed to take extra insulin. Taking insulin helps control your blood sugar without harming your baby. Insulin is a natural substance and is not addictive. If you did not have diabetes before pregnancy, you will most likely be able to stop taking insulin after your baby is born. In some cases, an oral antidiabetic agent, such as glyburide, may be used, but insulin is usually the preferred medicine. Your healthcare provider will prescribe your insulin. You will need to inject it one or more times a day. Insulin is injected into fatty tissue. It does not cross the placenta. That means it does not affect your baby the way taking a pill would. Your healthcare provider will teach you how to give yourself a shot. With practice, youll get comfortable doing it yourself. The best site for injecting insulin is your belly or abdomen. But you can also inject into an upper arm or thigh. Talk with your healthcare provider about where to give yourself a shot.Here are some steps to follow while injecting yourself with insulin: Pinch a fold of skin. Insert the needle at a 45 to 90angle. The best angle will depend on your body type, the length of the needle, and the injection site. Your healthcare provider will help you find which angle is best for you. Keeping the skin pinched, inject the insulin by pushing the plunger down. Apply pressure to the site for 5 to 8 seconds if you see blood or insulin leaking from the site after injection. Dont rub the injection area. Needles and syringes should only be used once. After using, throw them away in a puncture-proof container, or a sharps container. Dont throw needles in your household trash. Talk to your healthcare p Continue reading >>

Insulin Changes During Pregnancy

Insulin Changes During Pregnancy

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. It is not uncommon to need to make adjustments to your dose at least once a week. If you are not sure how to adjust your insulin doses, ask your diabetes in pregnancy team for advice. Adjusting insulin doses in pregnancy is more challenging than usual, so make sure you know how to get in touch with your diabetes team and be prepared to contact them more often. Early pregnancy changes Many women find it extremely challenging to maintain optimal blood glucose levels in the early stage of pregnancy with so many hormonal and physical changes occurring. For around the first six to eight weeks of pregnancy your blood glucose levels may be more unstable. Following these early pregnancy changes to your blood glucose levels, you may find that your insulin requirements decrease until the end of the first trimester. You may need to adjust your insulin doses at this time to reduce the risk of severe hypos occurring, sometimes without much (or any) warning. Preventing a hypo is better than treating one. Try not to miss any meals or snacks and check your blood glucose levels regularly. 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 as much as two or three times your daily pre- pregnancy insulin dose. This is because the hormones made by the placenta interfere with the way your insulin normally works - as the pregnancy hormones rise, so does your need for insulin. At this stage you are likely to need more mealtime, rapid-acting insulin, compared with the long- Continue reading >>

Diabetes And Pregnancy

Diabetes And Pregnancy

Diabetes can cause problems during pregnancy for women and their developing babies. Poor control of diabetes during pregnancy increases the chances for birth defects and other problems for the pregnancy. It can also cause serious complications for the woman. Proper health care before and during pregnancy can help prevent birth defects and other health problems. About Diabetes Diabetes is a condition in which the body cannot use the sugars and starches (carbohydrates) it takes in as food to make energy. The body either makes no insulin or too little insulin or cannot use the insulin it makes to change those sugars and starches into energy. As a result, extra sugar builds up in the blood. The three most common types of diabetes are: Type 1 The pancreas makes no insulin or so little insulin that the body can’t use blood sugar for energy. Type 1 diabetes must be controlled with daily insulin. Type 2 The body either makes too little insulin or can’t use the insulin it makes to use blood sugar for energy. Sometimes type 2 diabetes can be controlled through eating a proper diet and exercising regularly. Many people with type 2 diabetes have to take diabetes pills, insulin, or both. Gestational This is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Often gestational diabetes can be controlled through eating a healthy diet and exercising regularly. Sometimes a woman with gestational diabetes must also take insulin. For most women with gestational diabetes, the diabetes goes away soon after delivery. When it does not go away, the diabetes is called type 2 diabetes. Even if the diabetes does go away after the baby is born, half of all women who had gestational diabetes develop type 2 diabetes later. It’s important Continue reading >>

Diabetes In Pregnancy

Diabetes In Pregnancy

Gestational diabetes refers to diabetes that is diagnosed during pregnancy. Gestational diabetes occurs in about 7 percent of all pregnancies, usually in the second half of the pregnancy. It almost always goes away as soon as your baby is born. However, if gestational diabetes is not treated during your pregnancy, you may experience some complications. Causes Pregnancy hormones cause the body to be resistant to the action of insulin, a hormone made by your pancreas that helps your body use the fuels supplied by food. The carbohydrates you eat provide your body with a fuel called glucose, the sugar in the blood that nourishes your brain, heart, tissues and muscles. Glucose also is an important fuel for your developing baby. When gestational diabetes occurs, insulin fails to effectively move glucose into the cells that need it. As a result, glucose accumulates in the blood, causing blood sugar levels rise. Diagnosis Gestational diabetes is diagnosed with a blood test. Your blood glucose level is measured after you drink a sweet beverage. If your blood sugar is too high, you have gestational diabetes. Sometimes one test is all that is needed to make a definitive diagnosis. More often, an initial screening test is given and, if needed, a longer evaluation is performed. Gestational diabetes usually does not occur until later in pregnancy, when the placenta is producing more of the hormones that interfere with the mother's insulin. Screening for gestational diabetes usually takes place between weeks 24 to 28. However, women at high risk are usually screened during the first trimester. Risk Factors There are a number of risk factors associated with gestational diabetes, including: Being overweight Giving birth to a baby that weighed more than 9 pounds Having a parent or siblin Continue reading >>

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