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40 years old. Got pregnant naturally. Advised to take insulin novomix flexpen. Any suggestion?

Aug 2012
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Practicing since : 1999
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Dear Dr. My age being 40 years I became pregnant naturally while I have been administered 15 untis and 10 units of insulin Novomi Flex pen 50-50 the fasting sugar has been indicated as 146 fro 136 it has increased. I am really in a tensioned mood please help me.
Posted Thu, 28 Feb 2013 in Diabetes
Answered by Dr. Madhuri Patil 54 minutes later

Please increase your insulin Novomix 50/50 morning pre-breakfast dose to 18 units and pre-dinner dose to 15 units right away- you can do this even before you see your doctor as higher sugars in the first trimester play bad role and every minute is precious. But PLEASE DO NOT WORRY on this part. See your doctor as soon as possible after this.
Also, you need to increase the dose of thyroid tablet by about 25 percent. Discuss with your doctor right away for both the prescriptions.
Be informed that as your pregnancy progresses, your insulin requirements will increase gradually and you will need to switch to basal bolus insulin regimen (taking 4 to 5 pricks a day). Be prepared for this. It is for best interest of you and the baby.
Your target sugars for fasting should be less than 100 mg/dl and that of 2 hour post meals should be less than 130 mg/dl. Your HbA1c should be less than 6%. DO NOT WORRY FOR THE INITIAL HbA1c report as in your case it is likely to come upto 7%. After stricter control, increase in insulin doses and repeat test after 3 to 4 weeks will give you reading below 6%.
Watch your diet very strictly and eat every 3 hourly without fail. Even your bedtime snack to morning meal gap should be less than 6 to 7 hours.
Wish you all the best. You can keep in touch for guidance on self-manipulations of insulin doses during your pregnancy. Start T Folic acid 5 mg/day also. Take care.
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