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© Copyright, (2001 - 5/5/2011) The Ohio State University Medical Center, Division of Endocrinology - Upon request all patient education handouts are available in other formats for people with special hearing, vision and language needs, call (614) 293-3191.
Pregnancy
What is insulin?
Insulin is a hormone made by the pancreas. The pancreas is a small organ that lies behind and below the stomach. Insulin allows the food you eat to go into the body's cells for energy. A person cannot live without insulin.
Why do I need to take insulin?
You need to take insulin because your body:
Does not make enough of its own insulin,
Does not make any insulin, or
Cannot use the insulin it does make.
Why can't I take an insulin pill to control my diabetes?
Insulin cannot be taken in the form of a pill. The stomach juices would
destroy it before the body could use it. Insulin is most often taken as a
shot using a syringe, pen injector or insulin pump.
How long will I have to take insulin?
Some people only need insulin for a short time. This is often due to stress during pregnancy or illness, infection, surgery or when taking certain medicines such as steroids.
With Type 2 diabetes you may or may not need insulin to control your blood sugar or glucose. This is because your body still makes some insulin. You may or may not take oral medication to work with the insulin.
With Type 1 diabetes, you will need insulin for the rest of your life. This is because your body does not make any insulin. You will probably need two or more shots of insulin each day. Your doctor will decide how many shots and how much insulin you will need to take.
Where does insulin come from?
In the United States the most common type of insulin is human insulin.
These are made from harmless bacteria through DNA engineering.
What supplies will I need to take my insulin?
You will need:
•
Insulin vial, pen or cartridge
•
Syringes or pen needles
•
Alcohol swabs
Keep at least a week's supply of insulin and syringes on hand.
What time should I take my insulin?
It is best to take your insulin at the same time(s) every day. Do not vary
the time of your injection by more than one hour. If you are taking short
acting insulin, such as Regular, take your insulin 30 to 45 minutes before
eating. If you take quick acting insulin, such as Humalog or Novolog,
take your insulin within 15 minutes of eating.
Where should I give my insulin?
The preferred site for insulin injections during pregnancy is the abdomen. Using this site will not harm the baby because the needle will not reach the uterus even in late gestation.
Do not give your shot in the same spot. Move from one side of the abdomen to the other or stay at least an inch from the last injection site. Always give your insulin straight into the skin at a 90-degree angle.
Insulin is absorbed differently throughout your body.
Fastest absorption is your abdomen followed by the arm, then the upper leg.
What do I need to know about my insulin?
Check the label(s) on your insulin bottle(s) to be sure you have the right kind. You need to know the following about your insulin:
•
Name - such as NPH, Regular, Humalog, Novolog, Lantus
•
Strength - U-100 is used in the United States.
•
Brand - such as Novo-Nordisk, Eli-Lilly or Aventis
•
Expiration date - Do not use expired insulin.
•
When traveling, keep your syringes and insulin with you in case your luggage is lost. Do not store it in the trunk or glove compartment of your car.
•
Keep your insulin in the refrigerator. Extra bottles should also be kept in the refrigerator. Most insulin is only good for one month at room temperature, except for Levemir that lasts for 42 days. Avoid
exposing insulin to extreme temperatures and direct sunlight. Insulin pens and cartridges at room temperature are good for 14 days (NPH);
28 days (Regular, Humalog, Novolog, Apidra and Lantus); 42 days (Levemir).
•
Your doctor will choose the kind and amount of insulin you need.
Do not change the name, strength, species or brand of your insulin. Only your doctor should make these changes.
How does insulin work?
There are five kinds of injectable insulin:
•
Quick acting - Humalog (Lispro), Novolog (Aspart) and Apidra
•
Short acting - Regular
•
Intermediate acting
- NPH
•
Basal acting - Lantus and Levemir (these cannot be mixed in a syringe with other insulins)
•
Pre-mixed* - Novolin 70/30 or Humulin 70/30 = 70% NPH and 30% Regular
Humalog Mix 75/25 = 75% NPL and 25%
Humalog
Novolog Mix 70/30 = 70% NPH and 30%
Novolog
*Note: Pre-mixed insulins are not recommended during pregnancy.
This table shows when the insulins start to work, when they work the hardest (peak) and when they are gone from the body.
Type Starts Works Hardest
(Peak)
Duration
Quick Acting
•
Apidra
•
Humalog (Lispro)
•
Novolog (Aspart)
20 minutes 5 - 10 minutes 5 - 10 minutes
34 - 90 minutes 1 - 2 hours 1 - 2 hours
3.5 hours
3.5 hours
3.5 hours
Type Starts Works Hardest (Peak)
Duration
Short Acting
•
Regular 30 minutes 2 - 4 hours 6 - 8 hours
Intermediate Acting
•
NPH 1 - 2 hours 6 - 10 hours 16 - 24 hours
Basal
(Cannot be mixed with other insulins)
•
Lantus
•
Levemir
immediately immediately
None None
up to 24 hours up to 24 hours
What problems might happen with giving insulin shots?
Most people have no trouble giving their insulin injections. Talk with your nurse or doctor if you have any of the following problems:
•
Bruising
•
Dimpled areas
•
Redness
•
Hard, lumpy areas
•
Itching
Can I reuse my insulin syringes?
You may be able to reuse your syringes. If they can be reused, your nurse can show you how to safely do this. Because some people should not reuse their syringes, it is important for you to discuss this with your doctor or nurse.
Can I reuse my pen needles?
Because your pen needle must be removed to close the pen after
injecting insulin, you cannot reuse them.
What else can I do to control my diabetes?
Besides taking your insulin, there are several things you can do to help control your diabetes. These include:
•
Check and record your blood glucose (sugar) levels daily. If you notice patterns of low or high glucoses, call your doctor. (For more information, refer to the handouts on glucose monitoring, low blood sugar and high blood sugar.)
•
Follow your diet / meal plan
•
Exercise regularly
•
Keep your doctors' appointments
