Diabetes Home > Insulin and Pregnancy

Typically, most of the older types of insulins are considered safe for use during pregnancy. It is less clear if the newer insulin medications are also safe. If you are taking insulin and become pregnant, talk to your healthcare provider, as pregnancy usually affects your insulin requirements and you will most likely need more prenatal care than other pregnant women.

Using Insulin During Pregnancy: An Overview

Insulin is a medication used to treat diabetes. In general, older insulins are considered safe for use during pregnancy. At this time, it is not clear if the newer insulins are safe for use during pregnancy. Some healthcare providers are comfortable recommending them for pregnant women, while others are not.

Pregnancy Categories B and C

The U.S. Food and Drug Administration (FDA) uses a pregnancy category system to classify the possible risks to a fetus when a specific medicine is taken during pregnancy. Pregnancy Category B is given to medicines that have not been adequately studied in pregnant humans, but do not appear to cause harm to the fetus in animal studies. Pregnancy Category C is given to medicines that have not been studied in pregnant humans, but do appear to cause harm to the fetus in animal studies. Also, medicines that have not been studied in any pregnant women or animals are automatically given a "default" pregnancy Category C rating.
Newer insulins (such as Apidra® or Lantus®) are classified as pregnancy Category C medications. All older insulins (Humulin®, Humalog®, Novolin®, and NovoLog® insulins) are all Category B medications. As more information becomes available about some of the newer insulins, they may be switched from Category C to Category B medications, which happened with Levemir®, a relatively new insulin that is now classified as a Category B medication.
Although it was originally thought that insulin molecules are too large to cross the placenta, it is now known that some insulins, in some circumstances, may cross the placenta. In general, most healthcare providers consider insulin safe for use during pregnancy. It is very important for pregnant women with diabetes (including gestational diabetes) to control their blood sugar levels, and insulin can be useful to help keep those levels under control.
Both high blood sugar levels and low blood sugar levels can be dangerous to the fetus during pregnancy. Therefore, it is essential to control blood sugar levels in order to provide a safe and healthy pregnancy. Make sure to seek early prenatal care; as a pregnant woman with diabetes, you will likely require more care than the average pregnant woman.
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Last reviewed by: Kristi Monson, PharmD;
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