April 29, 2005
Insulin, Pregnancy
Question from Manila, Philippines:
I’ve had type 1 diabetes for five years and am now six weeks pregnant. I was taking Humulin N, 24 and 10 units before the pregnancy. My fasting blood sugar ranges from 140 mg/dl [7.8 mmol/L] to 200 mg/dl [11.1 mmol/L]. With a new doctor, she advised me to take only 12 and 6 units a day because, according to her, it might affect the baby. I’m not quite satisfied with her advice since, based on some of my readings, pregnant diabetic woman should take more insulin. I’m worried that it may affect the baby. Is there such thing as insulin overdose for pregnant woman? Is there an ideal amount of insulin recommended for pregnant diabetic woman?
Answer:
Insulin does not cross the placenta in any appreciable amount. Therefore, you will not overdose the baby on insulin. If anything, you need to increase your insulin dose to bring your blood sugar down. I recommend a target of fasting 60 to 90 mg/dl [3.3 to 5.0 mmol/L]; pre-meal less than 100 mg/dl [5.6 mmol/L]; and post-meal less than 130 mg/dl [7.2 mmol/L] at one hour or less than 120 mg/dl [6.7 mmol/L] at two hours. You should review your management with your doctor.
OWJ
