Insulin during pregnancy: Understanding Why It May Be Recommended

Insulin may be recommended during pregnancy to help keep blood glucose within the range agreed with your team. It can be part of care for diabetes present before pregnancy or for gestational diabetes. Starting insulin is a treatment decision, not evidence that you have failed at food or activity advice.

Ask why insulin is recommended now

For gestational diabetes, insulin may be needed when glucose remains above target despite other treatment, when metformin is unsuitable, or when levels and other clinical concerns justify starting sooner. The choice depends on your situation and local guidance.

Ask which readings or findings led to the recommendation and what improvement the team is aiming for. Our gestational diabetes overview explains the wider care plan.

Learn your own regimen before using it

There are different insulin types and schedules. Ask the team to demonstrate your prescribed pen, dose selection and injection technique, then watch you practise. Confirm when to take it in relation to meals, where to inject, how to store it and how to dispose of needles safely.

Keep the written instructions with the exact medicine name. Follow the adjustment plan you have been taught; do not borrow someone else’s dose. Insulin needs often increase as pregnancy progresses, so changes can be part of expected care. The monitoring guide explains how readings support that review.

Have a plan for low glucose

Insulin can make glucose fall too low. If you have symptoms such as shaking or sweating, or a reading below 4 mmol/L, take a fast acting source of glucose if you can swallow safely, following your team’s instructions. Recheck after 10 to 15 minutes and repeat treatment if it remains low. Once recovered, follow the advice for a meal or longer lasting carbohydrate.

Loss of consciousness, severe confusion or inability to swallow safely needs emergency help. Do not give food or drink by mouth to someone who cannot swallow safely. A support person should know your emergency plan, including any prescribed glucagon they have been trained to use.

Contact care when you are unwell

Ask for written instructions for illness, vomiting and missed doses before these situations arise. Seek urgent advice if you become unwell or have high glucose. Do not simply stop insulin because you cannot eat; contact the team for instructions.

Vomiting with deep breathing, fruity smelling breath, unusual sleepiness or confusion can indicate a serious emergency such as diabetic ketoacidosis. Seek emergency care rather than waiting for a routine glucose review. Ask your team how insulin will be reviewed around birth and afterwards.