About insulin

Insulin is a naturally occurring hormone that helps regulate blood glucose levels.

During pregnancy, women need to produce more insulin because of the extra demands on their bodies.

Some women have to take insulin to help keep their blood glucose levels within the recommended ranges.

Why you need it during pregnancy

When you are pregnant, it is important to regulate your blood glucose level as follows:

  • between 4.0 and 5.3 mmol/L, first thing in the morning
  • below 7.8 mmol/L, one hour after meals (timed from the start of the meal).

This will help reduce the risk of complications for you and your baby.

What it does

Insulin can help reduce the amount of glucose in your body, so you keep your fasting and post-meal glucose levels within the recommended range. (Fasting means after at least 8 hours without food or sugary drinks).

Two types of insulin are used in pregnancy.

  • Novorapid (mealtime insulin). This is a fast-acting, clear insulin that you take before meals. It stops glucose levels rising after you eat food.
  • Humulin I (night time insulin). This is a slow-acting, cloudy insulin that you take at bedtime. It works with your own body’s glucose, which is naturally released during the night. It stops morning glucose levels rising above the recommended limits.

Some women only need one type of insulin. Your diabetes team will tell you which type(s) of insulin they recommend.

Injecting insulin

How to give it

To give yourself insulin, you inject it into the fat of your outer thigh area, bottom or tummy (away from the belly button).

We will show you how to do this.

When to give it

  • Novorapid (mealtime insulin)
    • You need to inject Novorapid 10 minutes before you eat your meal.
    • If you are experiencing sickness, you can give it within 10 minutes after your meal.
    • You must always eat a meal after injecting yourself with insulin.
       
  • Humulin I (bedtime insulin)
    • You need to inject Humulin I just before you go to bed.

Side effects

Insulin stops your blood glucose going too high, but it can cause it to drop below 4.0 mmol/L.

If this happens you may experience a feeling of light-headedness, shaking, blurred vision or sweating. This is your body letting you know that your blood glucose is dropping below 4mmol/L.

Action to take

Lower glucose levels (below 4mmol/L)

Do the following.

  • Eat something sugary. For example 5 glucose tablets or 5 jelly babies or 150ml of Lucozade/regular cola.
  • Re-check your blood glucose levels after 10 minutes.
  • Eat another sugary item if your symptoms continue or blood glucose remains below 4.0 mmol/L.
  • Eat a biscuit or piece of fruit with your meal.
  • You still need to take your insulin at your next mealtime. If you are worried, you can take it immediately after food rather than before.
  • Think about why this might have happened. It might be because you ate less carbohydrate with the insulin, or were more active (for example shopping) at this time of day.
Higher glucose levels (above 7.8mmol/L)

No action is needed, but think about what you have eaten and what may have caused the rise in glucose levels.

If it always rises after one meal in the day (and is unconnected with eating more carbohydrates than usual), you may need to increase your insulin dose at that meal in the future.

We will discuss this with you in clinic. You can also call the diabetes midwives (see Contacts below) or request a call via the GDM-Health app which you can download for free from the Apple App store or Google Play Store.

Insulin storage and needle disposal

Follow this guidance on storage and needle disposal.

  • Store unused insulin in a refrigerator – it must not freeze.
  • Insulin in use can be kept at room temperature (less than 25 degrees) for up to 28 days.
  • Avoid keeping it in direct sunlight or heat (eg near radiators, fires or windowsills).
  • Dispose of all used needles in the sharps bin that we give you.

FAQs

Who do I need to inform about my diabetes?

  • Legally, you must tell the DVLA (Driving and Vehicle Licensing Agency) if you hold a driving licence and are going to be on insulin for more than 3 months (eg during or after delivery of your baby).
  • Let your motor insurance company know as well.
  • Your diabetes should not affect the DVLA or your insurance company.

Do I still have to monitor my blood sugars while pregnant?

Yes. This will keep you (and medical staff) informed about your insulin level during your pregnancy.

Do I need to continue metformin?

If you have been prescribed metformin, you must keep taking it as usual.

Do I still have to be careful with what I eat?

Yes. Follow the advice the dietitians and midwives give you.

Will my insulin dose change during pregnancy?

Most women have to increase their insulin dose while pregnant. The diabetes team will advise you on this.

Can I stop taking insulin after my baby is born?

Most women stop insulin immediately after their baby is born. We will give you a personal plan and discuss it with you at your obstetric antenatal clinic visit.

Renewing your insulin prescription

After we have taught you how to give yourself insulin, we will give you a letter for your GP. You must give this letter to your GP practice as soon as possible.

If you require a repeat insulin prescription, your GP should be able to give it to you.

If you experience difficulty with your repeat prescription, get in touch with the diabetes midwives (see Contacts below).

More information

DVLA and medical issues

Contact information

Kingston Hospital diabetes specialist midwives

Telephone:

07385 949 047

Leave your name, date of birth and contact number so we can call you back.

Email: krft.diaban@nhs.net