Endocrinology Book

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Gestational Diabetes Insulin ManagementAka: Insulin Management in Pregnancy

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  1. See Also
    1. Insulin Dosing
    2. Gestational Diabetes Insulin Management Intrapartum
  2. Indication
    1. Failed Gastational Diabetes Diet Management
  3. Calculate Ideal Body Weight
    1. Start with 100 pounds + 5 pounds per inch over 5 feet
    2. Add 30 pounds for pregnancy
    3. Convert to Kilograms: Pounds / 2.2
  4. Calculate Total Daily Calories
    1. Option 1
      1. Calories/day = Ideal Weight (in kg) x 35 KCal/kg
    2. Option 2 (if BMI > 30 kg/m2)
      1. Calories/day = actual weight (in kg) x 25 Kcal/kg
  5. Calculate Daily Insulin Dosing
    1. Insulin types
      1. Short acting: Regular or Lispro
      2. Long acting: NPH or Ultralente
    2. Insulin per day
      1. Some providers use 0.7 u/kg/day to start
      2. First half of pregnancy: 0.6 u/kg/day
      3. Second half of pregnancy: 0.9 u/kg/day
    3. Divide Insulin Dosing over course of day
      1. Morning: 2/3 of Insulin
        1. NPH Insulin: 2/3
        2. Regular Insulin: 1/3
      2. Evening: 1/3 pf Insulin
        1. NPH Insulin: 1/2
        2. Regular Insulin: 1/2

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