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Gestational Diabetes Insulin Management

Aka: Gestational Diabetes Insulin Management, Insulin Management in Pregnancy

See Also
1. Insulin Dosing
2. Gestational Diabetes Insulin Management Intrapartum
Indication
1. Failed Gastational Diabetes Diet Management
Protocol: 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
Protocol: 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
Protocol: Calculate Daily Insulin Dosing
1. Insulin types
  1. Short acting: Regular or Lispro
  2. Long acting: NPH or Ultralente
    1. Note that Lantus and Levemir are not recommended due to lack of data in pregnancy
2. Insulin per day (based on pre-pregnancy weight)
  1. Some providers use start of 0.7 u/kg/day
  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

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 1/28/2010 and last published on 5/10/2012.

This is one of 5737 pages in the Family Practice Notebook