Insulin in Gestational Diabetes:

Mama has started her daily dose of insulin!
She tried her best to keep the levels of glucose low for almost 2months, but now as she is getting bigger and gaining weight she is having problems in her regular exercises and walking, that in effect is increasing the blood glucose level to some extent.

Taking insulin everyday is not a matter of joke.
Doctor has prescribed insulin 3times a day, 30minutes before breakfast, lunch and dinner. I have heard that rapid action insulin can be given safely to pregnant ladies with GDM. There are somne types of insulin available like short acting, intermediate, long acting. But these are not very safe to be used in GDM.

In the initial stage mom was very nervous and also reluctant to take this injection everyday. As you already know she is taking proluton depot injection every week and that is also so much painful. Hence she had some fears that again taking 3injections everyday will make her life miserable!
But as she understood that she can safeguard her pregnancy her taking insulin injections daily, she made up her mind that whatever pain she will have she will sustain it but she cannot get me in trouble. I love you momma! You are doing so much for me. Whenever I think of your pain and anguish I am really speechless..you are a Mother-one in a million..I promise you I will repay you one day no matter what !

Now everyday she is pricking herself with diabetes pen needle.. Everyone say that they do not hurt too much and taking insulin by pen is so much simple and easy. But I will tell you the real fact. It does pain..specially if the needle becomes old or is used for 2days consecutively. You may say it does not pain in comparison to the normal syringe injections.

Mom was searching the net and has come to know a few facts and figures about taking insulin in gestational diabetes.

Take insulin and/or other medications as prescribed

What is it?

Even if you do everything your health care provider tells you to manage your gestational diabetes, you still might need to take insulin during your pregnancy to keep it under control. You already know that insulin moves glucose out of your bloodstream and into your cells to use as energy; you may need extra insulin to lower your blood glucose level. The only way to get extra insulin into your body is to inject it under your skin with a needle. Taking insulin is the same as any other part of this treatment plan. It's just another way to help you stay healthy.

Why do I have to do it?

You may have to include small amounts of insulin in your treatment plan if:

* Your blood sugar level is too high.
* Your blood sugar level is high too many times.
* Your blood sugar level remains high, but you are not gaining much weight or are not eating poorly.
* You cannot safely add physical activity to your treatment plan.

In these cases, the best action for maintaining a healthy pregnancy is to add insulin. Insulin does not hurt the fetus. The daily records that you keep help your health care provider decide when and if it's time to begin insulin. That's why it's important to keep good records.
Here are some other things you should know about insulin:

* If you need to take insulin, it does not mean that you didn't try hard enough or that you failed at taking care of yourself. It just means that your body has a high level of insulin resistance and needs some help getting glucose level back into healthy range. (Refer to the Knowing your blood sugar level and keeping it under control: How do I know I'm doing it right? section of this booklet for more details on the healthy range for glucose.)
* Taking insulin does not mean you have type 1 diabetes. People with type 1 diabetes have to take insulin shots every day of their lives because their bodies don't make enough insulin. As a woman with gestational diabetes, taking insulin does NOT mean that you now have type 1 diabetes. It only means that your body needs some extra help to balance its insulin and glucose levels. After your baby is born, your diabetes will likely go away, and with it, your need to take insulin.
* An increase in the amount or dosage of insulin you need does not mean that your pregnancy is in danger. The amount of insulin you take will probably increase as your pregnancy goes on. Because your insulin resistance increases as your pregnancy continues, your body needs more insulin to overcome this resistance. The goal is to keep your blood sugar under control, no matter how much insulin it takes. Most women take two insulin shots each day, but you may get better glucose control with three injections.
* You may need more insulin if you are under high amounts of stress or if you are sick because your blood sugar level gets higher on its own in these cases. Some medicines can also cause blood sugars to rise above the healthy range.

How do I do it?

Your health care provider will teach you how to give yourself insulin shots, if you need them. Use this answer sheet to write down what your health care provider tells you about your insulin treatment.

When do I do it?

How often you need insulin shots will depend on your body. Your health care provider will tell you how often to take the shots and at what times of day. Make sure you follow his or her advice about taking insulin to help ensure the safety of your pregnancy.

Special instructions for women taking insulin

* Follow a regular eating schedule. Your health care provider can tell you when to take the insulin and when to eat your meals so that the timing of both is correct. Do not skip or delay meals and snacks when taking insulin because this can affect your glucose-insulin balance.
* Know the symptoms of low blood sugar. If your blood sugar level drops below 60 at any time, you have hypoglycemia (hypo means low, and glycemia means sugar). Low blood sugar can be dangerous. Hypoglycemia is not common in women with gestational diabetes, but you are at greater risk for it if you take insulin. The table shown here describes some reasons that low blood sugar might occur and some of its symptoms.

KNOW THE SYMPTOMS OF LOW BLOOD SUGAR

Why does low blood sugar occur?
* Too much exercise
* Skipping meals or snacks
* Delaying meals or snacks
* Not eating often enough
* Too much insulin

How might I feel if I have low
blood sugar?
* Very hungry
* Very tired
* Shaky or trembling
* Sweating or clamminess
* Nervous
* Confused
* Like you're going to pass out or faint
* Blurred vision

Or…You might feel fine.

* Know when your insulin is working its hardest. Low blood sugar is more common at these times, depending on how your body uses insulin and glucose.
* Be careful about doing physical activity, but remain active. Because both insulin and physical activity lower your blood sugar level, when combined they can cause your blood sugar level to drop very quickly. Test your blood sugar before you do any physical activity. If your level is low, eat something and test again to make sure your level is higher before you start an activity. Be smart about how much physical activity you do, how much you eat, and how much insulin you take.
* Be prepared. Take your insulin supplies with you when you go out, especially if you are going to be gone a long time. You should also take some form of sugar with you, in your purse, in your car's glove compartment, or in your pocket, in case your blood sugar drops too low. The best form of sugar for an emergency is glucose paste or glucose tablets. You can buy these at the drug store or pharmacy. Ask your health care provider for more information.
* Test your blood sugar if you start to feel dizzy, faint, or tired.
* Report any abnormal blood sugar level to your health care provider right away, in case a change in your treatment plan is needed.

taken from:http://www.nichd.nih.gov/publications/pubs/gest_diabetes/

Gestational diabetes: Giving yourself insulin shots

If you have gestational diabetes and you have not been able to keep your blood sugar levels within a safe range by changing the way you eat and by exercising, you will need insulin shots.

Key points

* Taking insulin can help prevent high blood sugar. High blood sugar can lead to problems for you and your baby.
* Insulin is given as a shot into the fatty tissue just under the skin. In pregnant women, insulin usually is given in the upper arm or thigh.
* At first, you may feel nervous about giving yourself insulin shots. But, after a little while, it will become a routine part of your day. It is not hard to learn how to do, and any sting you might feel will not last long. More than 500,000 people in the United States do this every day. You can, too.
* It is also important to:
o Have the right dose of insulin, especially if you are giving two types of insulin in the same syringe.
o Practice how to give your shot.
o Store the insulin properly so that each dose will work well.


What does it mean to prepare and give an insulin shot?

Insulin comes in small glass bottles (vials) and cartridges. Each type of container is sealed with a rubber lid. One vial or cartridge contains many doses. To remove a dose of insulin from:

* A vial: You will use an insulin syringe to get the insulin and to give yourself a shot.
* A cartridge: You will use a pen-shaped device called an insulin pen. The cartridge fits inside the pen and the dose of insulin is set with a dial on the outside of the pen. The pen (with the cartridge inside) is used to give the medicine. There are disposable and reusable insulin pens. Each pen works slightly differently.

Note: If you are using an insulin pen, talk with your doctor or pharmacist about how to use the pen correctly. Giving insulin with these pens is not covered in this information.

To give an insulin shot, the needle (attached to the syringe) is inserted through the skin. The medicine is pushed from the syringe into fatty tissue just below the skin. In pregnant women, insulin usually is given in the upper arm or thigh.

Your doctor may have you take two types of insulin at the same time. Most types of insulin that are prescribed to be taken at the same time can be mixed together in the same syringe.

Why give insulin?

Normally, insulin is made by the pancreas. Insulin helps sugar (glucose) enter cells, where it is used for energy. It helps our bodies store extra sugar in muscles, fat, and liver cells. Later, that sugar can be released if it is needed. Without insulin, the body cannot use sugar, causing the blood sugar level to get too high.

If you have gestational diabetes during pregnancy, your pancreas cannot produce enough insulin. If regular exercise and changing the way you eat do not keep your blood sugar level within a safe range, you will need to take a man-made form of insulin. Keeping your blood sugar level within a safe range prevents complications for you, for your unborn baby (such as growing too large for normal delivery), and for your baby after birth (such as low blood sugar levels).

People who have type 1 diabetes and some people who have type 2 diabetes also need to take insulin.

How to prepare and give an insulin shot

Your doctor will help you learn to prepare and give yourself insulin shots. Here are some simple steps to help you learn how to do it.
Get ready
To get ready to give an insulin shot, follow these steps:

1. Gather your supplies. You will need an insulin syringe, your bottle of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Most people keep their supplies in a bag or kit so they can carry the supplies with them wherever they go.
2. Check the insulin bottle label, expiration date, and contents. When you use an insulin bottle for the first time, write the date on the bottle. On the 30th day after opening it, throw the bottle away. Insulin may not work as well after 30 days.
3. Wash your hands with soap and running water. Dry them thoroughly.

Prepare the shot

Your preparation will depend on whether you are giving one type of insulin or mixing two types of insulin.

* To prepare a shot with a single type of insulin, follow the instructions in the slideshow of steps for preparing a single dose of insulin.
* To prepare a shot containing two types of insulin, follow the instructions in the slideshow of steps for preparing a mixed dose of insulin.

Prepare the site

Before giving your shot, take the time you need to do the following:

* Choose the place. See a diagram of shot areas for guidance. If you give your shots in different places on your body each day, use the same site at the same time of day.
* Clean the area. If you use alcohol to clean the skin before you give the shot, let it dry.
* Relax your muscles in the area of the shot.

Give the shot

Follow these steps for giving an insulin shot:

1. Slightly pinch a fold of skin between your fingers and thumb of one hand.
2. Hold the syringe like a pencil close to the site, keeping your fingers off the plunger. Usually the syringe is at a 90-degree angle to the skin site. If you are thin, you may need to insert the needle at a 45-degree angle. This will prevent the insulin from being injected into muscle, causing it to be absorbed more quickly.
3. Quickly push the needle all the way into the pinched-up area.
4. Push the plunger of the syringe all the way in so the insulin goes into the fatty tissue.
5. Remove the needle slowly at the same angle that you inserted it. If you bleed a little, apply pressure over the area using your finger, a cotton ball, or piece of gauze. Do not rub the area. Check your blood sugar more frequently on the days when bleeding occurs.
6. Replace the cover over the needle. Although syringe manufacturers do not recommend it, some people reuse their syringes until the needle becomes dull or bent. If you plan to reuse your syringe, see precautions when reusing syringes.

Clean up and storage

After giving your shot:
* Store your insulin properly so that each dose from the bottle will work well.
* Do not throw your used syringe, needle, or lancet in a trash can. You can dispose of it in a metal container that either has a lid that screws on or a lid that you tape down tightly. You also can buy special containers for disposing of used needles and syringes. Talk with your local trash disposal agency or your doctor about how to get rid of the container.

Other suggestions for success and safety

To help you be safe and successful in giving your insulin shots:

* Teach someone else to give your insulin shots. Have that person give you a shot from time to time so they will know how to do it in case of an emergency.
* Do not mix other medicine with insulin without your doctor's instruction. If you are taking two types of insulin, ask your doctor or pharmacist whether they can be mixed in the same syringe.
* Never share syringes with another person because of the risk of getting diseases that can be transferred through blood, such as HIV or infection of the liver (hepatitis).

Insulin injection areas for gestational diabetes

These pictures show the areas of the body where insulin can be injected. You can give yourself a shot in:

* The top outer area of the thighs. Insulin usually is absorbed more slowly from this site, unless you exercise soon after injecting insulin into your legs.
* The upper outer area of the arms.
* The buttocks.

Change the spot where you give the shot slightly each time, so that you do not get bumps or pits in your skin. For example, use the right upper arm 5 times in different places, then use the left upper arm in 5 places.

Precautions when reusing insulin syringes:

Some people with diabetes use their insulin syringes more than once to save money. Talk with your doctor before reusing your syringes. Some people with diabetes should not reuse their syringes, including people who have:

* Trouble seeing clearly.
* Trouble using their hands.
* Infections or open wounds.

Some precautions to take if you reuse syringes:

* Put the cover back on the needle after use. The safest way to do this is to place the cover and syringe on a flat surface and slide the cover over the needle without letting the needle touch either the flat surface or your fingers. Only the inside of the cover should touch the needle. Do not hold the syringe straight up; you may accidentally stick yourself.
* Do not clean the needle with alcohol. Alcohol removes the silicone covering on the needle, causing it to become dull.
* Store the syringes at room temperature. It is best to store them with the covered needle pointing up to prevent insulin from blocking the needle opening.

Dispose of reused syringes in safe containers when:

* The shot hurts when you use the syringe.
* The needle becomes dull. Needles usually are dull after being used more than 5 times.
* The needle is bent or has touched something other than your skin.
* You notice redness or signs of infection at the place where you have given the shot. Let your doctor know if you have an infection.

taken from:http://health.yahoo.com/diabetes-treatment/