Insulin During Pregnancy: When You Need It And Safety Measures

check_icon Research-backed

Image: Shutterstock


If you have developed diabetes during pregnancy, a healthy and nutritious diet and routine workout usually help normalize blood glucose levels. However, sometimes, your doctor may prescribe insulin during pregnancy to maintain your blood glucose levels within the normal range (1). But how does one get gestational diabetes (GD) during pregnancy?

When pregnant, the placenta in a woman’s womb secretes hormones essential for the baby’s development. However, these hormones can impair insulin activity and induce GD in certain pregnant women.

Read this post to know the safety profile of oral insulin medications and injections in pregnancy.

When Do You Need To Take Insulin During Pregnancy?

Women with diabetes do not produce insulin or their body stops responding to the natural insulin, increasing the blood glucose levels. Therefore, insulin is required and may be prescribed to keep your blood glucose levels in control (2).

Blood glucose levels during conception and pregnancy are important to be normal both for development of a healthy fetus and to maintain normal fetal growth and development. Glucose intolerance (the body cannot metabolize blood glucose) during or before pregnancy could lead to certain complications. Insulin treatment helps in maintaining these levels if diet and exercise do not control it sufficiently..

Is Insulin Safe To Treat Gestational Diabetes During Pregnancy?

In clinical practices, insulin is the first-line of treatment for type1 and type 2 diabetes and uncontrolled GD during pregnancy (3). According to the American Diabetes Association (ADA), insulin administered through injection, insulin pen, or through an insulin pump is safe for pregnant women (4). Your doctor will put you on insulin only if it is necessary.

Does Insulin Affect The Baby During Pregnancy?

ADA says that insulin does not cross the placenta, and so it does not affect the baby.

Can Insulin Cause Miscarriage?

No, insulin is not known to cause miscarriage.(5).

What Is The Suggested Drug Therapy For Treating Gestational Diabetes?

The guidelines of the American College of Obstetricians and Gynecologists (ACOG) recommend insulin as the first-line treatment for gestational diabetes that cannot be controlled by dietary and lifestyle changes.

The US National Institute for Health and Care Excellence (NICE) guidelines advise an initial treatment of insulin either with or without metformin for women with complications of gestational diabetes (6). Insulin is available in only injection and pump form.

Other oral medications, such as metformin, may be prescribed to treat gestational diabetes and mild hyperglycemia. However, this is not standard practice. (6).

Which Insulin Is Safe During Pregnancy?

Your doctor is the best person to determine the type of insulin for you.

According to an article published in the American College of Clinical Pharmacy, intermediate-acting neutral protamine Hagedorn (NPH) insulin, the long-acting NPH, long-lasting insulin glargine, and regular insulin, or short-acting insulin may be considered by the doctors for treating GD (6).

Can You Inject Insulin On The Stomach When Pregnant?

Insulin should be injected into any fatty tissue. According to a publication in the Indian Journal of Endocrinology and Metabolism, the abdomen is a safe site for insulin injection during pregnancy.

The article recommends the below techniques to follow during the various stages of pregnancy.

  • First trimester: You can inject insulin into your abdomen. If you’ve been injecting it on the abdomen before conception, there is no need to change the injection site or technique.
  • Second trimester: Lateral parts of the abdomen are suitable for injection, but avoid the skin overlying the fetus (7).
  • Third trimester: The Forum of Injection Techniques, India, suggests that insulin be injected into the abdomen but by ensuring that the skin fold is properly raised. If you are apprehensive about getting an injection on your abdomen, talk to your doctor about changing the injection site to the thigh, upper arm, or buttock (8).

Talk to your healthcare provider for initial guidance on injecting insulin. With time, you will become comfortable in safely administering insulin by yourself.

Are There Any Side Effects Of Using Insulin During Pregnancy?

Insulin is crucial to protect the mother and the growing baby from the effects of gestational diabetes. However, the injection itself might have a few side effects, such as (9):

  • Redness, swelling, and itching near the injection site
  • Skin thickening or a little depression in the skin
  • Weight gain
  • Constipation
  • Shortness of breath
  • Wheezing
  • Dizziness
  • Blurred vision
  • Sweating
  • Fast heartbeat
  • Weakness
  • Muscle cramps
  • Swelling of the arms, legs, feet, ankles and lower legs

If you experience any of the following symptoms, call your doctor.

Most women successfully manage gestational diabetes with insulin during pregnancy. However, your doctor will suggest insulin only when your diabetes is uncontrolled with diet and exercise. The type and dosage of insulin will be based on the severity and stage of your pregnancy. Moreover, insulin is safe for pregnant women as no reports suggest its adverse effects in pregnancy or the fetus. However, it is crucial to be in close contact with your doctor to facilitate close monitoring and favorable pregnancy outcomes.


MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Gestational Diabetes Information- Commencing Insulin Therapy; Department of Health; Queensland Government
2. Laura Hieronymus, and Patti Geil; Expecting the best: Diabetes, Pregnancy, and Blood Glucose Control; National Federation of the Blind
3. Alyson K. Blum; Insulin Use in Pregnancy: An Update; NCBI (2016)
4. Prenatal Care; American Diabetes Association
5. Karen L. Whalen and James R. Taylor; Gestational Diabetes Mellitus; American Academy of Clinical Pharmacy
6. Pregnancy if You Have Diabetes; National Institute of Diabetes and Digestive and Kidney Disease
7. Sanjay Kalra, et al.; Addendum: First injection technique recommendations for patients with diabetes, Forum for Injection Techniques India; NCBI (2013)
8. Nikhil Tandon, et al.; Forum for injection technique and therapy expert recommendations, India: The Indian recommendations for best practice in insulin injection technique, 2017; Indian Journal of Endocrinology and Metabolism
9. Insulin Injection; MedlinePlus; US National Library of Medicine
Was this information helpful?
The following two tabs change content below.

shreeja pillai

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer, she aims at providing informative articles on health... more

Dr. Christian Pope

Dr. Christian Pope is Board-certified in Obstetrics & Gynecology, and a Fellow of the American Academy of Obstetricians and Gynecologists. He is a long-standing medical staff member and past chairman of Obstetrics and Gynecology at St. Luke's Hospital of SouthCoast Hospitals in New Bedford, Massachusetts and is in private group practice at Hawthorn Medical Associates, Inc. He is a member... more