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Introduction

When blood sugar levels cannot be controlled with oral medications alone, human insulin is used to treat type 1 diabetes, a condition in which the body does not produce insulin and cannot control blood sugar levels, or type 2 diabetes, a condition in which the body does not produce or use insulin normally, resulting in excessive blood sugar levels. Human insulin belongs to a group of drugs known as hormones. The insulin that the body naturally produces is replaced with human insulin. It functions by assisting the body's other tissues in transferring blood sugar, which is used there for energy. It also prevents the liver from generating additional sugar. This is how all of the available forms of insulin function. The only differences between the insulin kinds are in how soon they start to act and how long they stay effective at regulating blood sugar.

What is Gestational diabetes ?

For women without a history of diabetes, gestational diabetes is a form of the diabetes that can develop during pregnancy. After the baby is born, gestational diabetes typically disappears. If your doctor advises differently, it's crucial to get a follow-up glucose tolerance test six to twelve months after the baby is born or before attempting a second pregnancy to ensure you are no longer diabetic. You can increase the likelihood of a successful pregnancy and healthy baby by controlling your gestational diabetes.

Who is susceptible to gestational diabetes?

The prevalence of gestational diabetes in pregnant women ranges from 3% to 8%. In most cases, it is discovered between 24 and 28 weeks, though it might appear earlier. Receiving a gestational diabetes diagnosis might be distressing and unanticipated. It's critical to receive support and assistance in controlling it by reaching out.

Gestational diabetes is more likely to affect some women. Among the women in this category are these: 

• are overweight or obese
• have a family history of type 2 diabetes
• are older than 40 years of age
• use some steroids or antipsychotic drugs.
• having experienced gestational diabetes in the past
• previously given birth to a child weighing more than 4,500 grams.
•  having experienced a difficult pregnancy in the past
•  have PCOS, or polycystic ovarian syndrome.

 There are some pregnant women without established risk factors for gestational diabetes.

Education about the use of insulin during pregnancy

• It is critical that you receive guidance and support on the administration, storage, and operation of insulin from your physician or diabetes educator.
• It is crucial that you understand the warning signs and symptoms of hypoglycemia, how to manage it, and the safe blood glucose levels for driving. Insulin can occasionally cause blood glucose levels to drop too low.

What happens after the birth of a baby?

• After your baby is born, you normally stop injecting insulin to help manage gestational diabetes. This is due to the fact that after giving delivery, women's blood glucose levels typically recover to the ideal range rather quickly.
• It's crucial to check your baby's blood glucose levels after birth to make sure it hasn't dropped too low. If so, you can cure it by giving your child formula or breast milk. It is advised that you breastfeed your child because it is best for both of you.
• After your baby is delivered, your blood glucose levels will be monitored for a few days to make sure they are within the appropriate range. It is customary to check blood sugar two hours after eating and before breakfast. Six to twelve weeks after the baby is born, an oral glucose tolerance test (OGTT) is performed to see if your diabetes has resolved.
• If you live in a high-risk location or are unable to socially distance yourself from the pathology center, it is advised that you postpone the OGTT testing for a period of six months during COVID-19. If you intend to become pregnant again or before your child turns 12 months old, it is advised to have an OGTT. Follow your physician's advice.
• Although a child whose mother had gestational diabetes won't have diabetes at birth, they might have a higher chance of type 2 diabetes in the future.

What side effects of insulin injection during pregnancy cause?

There may be adverse effects from human insulin. Inform your physician in the event that any of these symptoms worsen or persist:

• Skin thickening (fat build-up)
• Skin redness
• Swelling
• Itching at the injection site
• A small depression in the skin (fat breakdown)
• Constipation
• Weight gain

Certain adverse effects may be dangerous. Give your doctor a call right away if you encounter any of the following symptoms:

• Rash and/or itching throughout the entire body 
• Dyspnea 
• Wheezing 
• Lightheadedness
• Hazy vision
• Rapid heart rate
• Perspiration Weakness in breathing or swallowing
• Muscles Cramps
• Irregular pulse
• Significant weight gain 
• Edema of arms, hands, feet, ankles, or lower legs

Conclusion

Insulin therapy is still the recommended course of treatment for uncontrolled gestational diabetes mellitus (GDM) and type 1 and type 2 diabetes. The insulins with the greatest human pregnancy data are NPH, insulin lispro, insulin aspart, and regular insulin. Clinicians' ability to accurately weigh the advantages and disadvantages of modifying insulin therapy will become increasingly important. It's also crucial to share the data with the patient so she can help choose the optimal insulin dosage. For the greatest fetal results, strict glycemic control must be maintained throughout pregnancy, regardless of the regimen selected.