If you were already using insulin
Your team may change your doses or suggest that you try a regimen that is more effective. You may be using a syringe, a pen or a pump.
If you are new to insulin
Insulin only works if it is injected – so if you need to take it, then this will mean injecting. If you need to start giving yourself insulin injections, your diabetes team will show you how to inject yourself, what times you need to do it, how to keep your insulin and where to put the used needles.
Many people do not like the idea of injecting, but try not to worry – injecting insulin is not like injections you may have had in the past. You will be using either a syringe or a pen, with a very fine needle. These are not usually painful, though they may feel worse if you are anxious. Once people learn to relax, they often find injecting very straightforward.
There are various types of insulin, ranging from rapid-acting insulin, which needs to be injected at mealtimes, to long-acting insulin, which is injected at the start or end of the day. Some fast-acting types take effect quickly, while others take longer. You may be given a combination of both – a long-acting insulin to last the day plus fast-acting to take before meals.
"Before I got pregnant I was on, say, seven units of insulin for breakfast, but now I'd gone up to 40 units. Throughout the pregnancy my insulin requirements were changing constantly." Prisha, mum of two
Another option is pump therapy, which delivers regular doses over a number of days. This may be offered if insulin injections are not bringing your glucose levels under control.
Insulin pump therapy
- An insulin pump is a small device that delivers regular doses of rapid-acting insulin into your body over a two-to-three day period. You can activate it by simply pressing a button on a handheld device that looks much like a mobile phone, so that you receive a continuous supply rather than fewer longer-acting doses. You can then have extra doses to cover you for meals and snacks. The insulin flows through a tiny, flexible tube called a cannula, which runs under the skin and is left in place through the day. The only injecting you need to do is to replace the cannula, two or three times a week.
- Using a pump helps you be more flexible as you can eat when you want. It also helps you have tighter blood glucose control as you can select the right insulin dose in real time. You will get detailed training to understand what doe to select, based on how much carbohydrate you have eaten, and also make adjustments based on how much exercise you do.
- There are a number of types of pump, with a range of features. Some include blood glucose meters.
"I just couldn’t get my control as tight as the team wanted. I had a couple of appointments where I was in tears. Then I met a dietician who said I was the ideal candidate for the pump. It was a lot of hard work, but it was the best thing I ever did." Laura, mum of one
If you are having problematic severe hypoglycaemia, unstable blood glucose levels or if your healthcare team need more information about the changes in your blood glucose levels, you may be suitable for continuous glucose monitoring. This involves placing a small sensor under your skin which monitors your glucose levels automatically.
Diabetes and driving
If you are taking anything for your diabetes, you need to check the regulations with the DVLA because of the risk of having low blood glucose when driving.
In general, if you are treating your diabetes through diet or tablets alone and drive a car or motorcycle, you don’t need to tell the DVLA. If you drive larger vehicles or are treated by insulin, you may need to. Either way, make sure you tell your car insurer, or your insurance may be invalid.
- Diabetes UK. Insulin pumps, http://www.diabetes.org.uk/Information-for-parents/Diabetes-care/Insulin...
- NICE (2015) Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period, NICE guideline, National Institute for Health and Care Excellence
Keeping your blood glucose levels within safe limits is a hugely important part of managing your diabetes, but you also need to think about your physical well-being.
Hypoglycaemia happens when your blood glucose levels drop too low. This is more likely to happen if you treat your diabetes with insulin. If you treat your diabetes with diet or metformin alone, you are generally not at risk.
Hyperglycaemia is caused by blood glucose levels rising too high.
While you are pregnant, you will be at much higher risk of hypoglycaemia – especially in the early weeks. At the same time, you may not have your usual early warning signs (hypo unawareness), and the symptoms may be more severe than usual.
If you are ill with type 1 or 2 diabetes, more glucose is released into your bloodstream and your body becomes resistant to insulin.
Managing your blood glucose levels can be much harder after you become pregnant. As your body changes, so do your blood glucose levels.
If you have type 1 or 2 diabetes in pregnancy you will get extra care.
You will need to manage your type 1 or 2 diabetes in pregnancy by checking your blood glucose levels and adjusting your treatment according to the results.
Women with type 1 or 2 diabetes are at higher risk of some complications but the majority have normal pregnancies and healthy babies. There is much you can do to reduce the risks, for you and baby.
ℹLast reviewed on September 1st, 2015. Next review date September 1st, 2017.