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September 28, 2000

Family Planning

Question from Grand Rapids, Michigan, USA:

I have type 2 diabetes. I take N (approximately 130 units) each night around 11 pm, and recently I've been given a Humalog pen and a chart for dosage for use when my blood sugars rise above 150 mg/dl [8.3 mmol/L]. I am also trying to get pregnant with the help of fertility specialists. I have two questions: First, if I know I'm going to be up late (past 1 am or so) should I take my nightly insulin later? Secondly, how quickly is a woman's blood sugar affected by pregnancy? I'm trying to stay in very good control, but yesterday my sugars were high all day, and I wondered if, perhaps, the latest insemination was successful and this was a side-effect of pregnancy.

Answer:

I would suggest taking your injection at the usual time. With pregnancy, blood sugar control can become erratic very quickly (within a few days or week of embryo implantation), but this does not always occur. Therefore, you should also look for other reasons for elevated blood glucose values. I would also suggest that you speak with your endocrinologist about your insulin regimen. You may do better during pregnancy with split dosing of NPH or even Ultralente and Humalog. Start taking folic acid supplement as well.

OWJ