Generic Name: Insulin
Indications: Treatment of diabetes
FDA Drug Category: B

Summary Recommendations
: Insulin is commonly given to patients to treat diabetes in order to lower blood sugar glucose. Controlling diabetes during pregnancy and lowering blood glucose sugar can reduce the risk of pregnancy complications and increased fetal weight. Your insulin dose may change during pregnancy. You should always keep prenatal appointments and track blood glucose levels daily.

General Precautions
: Diabetes can be a dangerous health condition during pregnancy. You should always maintain diabetes care and good blood sugar control during pregnancy and after birth. Diabetes care can be extremely specialized so your obstetrician will likely leave care to your primary care physician for medication and alternative treatment options.

Various types of insulin exist, including short-acting, intermediate-acting, long-acting and fast-acting.

Effect While Trying to Conceive: While insulin is not directly associated with infertility, diabetes, especially when it is uncontrolled can affect fertility in both men and women. Treating diabetes and lowering blood sugar glucose may improve fertility. If diabetes is found during medical testing, insulin treatment may help resolve the hormone imbalance, leading to more balanced fertility hormones and improved fertility.

Effects on Pregnancy: Insulin is the drug of choice for treatment of diabetes during pregnancy. Insulin does not cross the placenta, and it does not go to the fetus. However, sugar glucose in the mother does cross the placenta and go to the fetus and can adversely affect the fetus. That is why taking insulin is important so the elevated sugar in the mother's blood does not adversely affect the fetus. Doctors also use the drug to treat gestational diabetes if diet and exercise changes are not effective. Type 1 diabetes is a chronic condition that cannot be cured. Typically, women with type 1 diabetes are used to injecting insulin and altering insulin doses as needed as the body changes. During pregnancy, insulin doses could change often – so pregnant women may require more medical appointments during pregnancy than before pregnancy.

Gestational diabetes is a pregnancy complication that can be effectively treated with diet and exercise, in some cases. If insulin is needed, doses will change often, especially as the pregnancy progresses. Insulin must be injected multiple times every day with regular blood glucose monitoring to ensure treatment is working.

Safe During Breastfeeding
: Insulin is safe for use while breastfeeding. There are clinical studies that report a possible decreased risk of type 1 diabetes in infants breastfed by mothers treated with insulin. Newer drugs have less medical history of use during breastfeeding, so older drugs with a more established history may be used in place of newer drugs.