What is gestational diabetes?

How to use an insulin pen when you're pregnant

1. Know which type of insulin pen you're using.
   

   Insulin pens are either reusable or disposable. For a reusable pen, you put the insulin cartridge into the pen. Disposable pens already have an insulin cartridge. Before using cloudy insulin, such as NPH and premixed insulin, gently roll the pen between your palms 10 times. Then tip the pen up and down 10 times. Do not shake the pen. The insulin should look milky white.

2. Attach the needle to the insulin pen.
   

   Follow the directions for how to screw a new needle onto your pen. Remove the outer cap from the needle. Keep this outer cap. You will use it later to safely dispose of the needle. Remove the inner cover from the needle. Be careful not to poke yourself.

3. Prime the needle.
   

   Before each shot, prime the needle. Priming removes air from the needle and helps make sure you're getting the right dose.

   Turn the dose knob to 2 units or to the amount that your pen's manufacturer recommends. Hold your pen with the needle pointing up. Tap the cartridge holder gently to move any air bubbles to the top.

   Push the injection button all the way in. Watch for a stream or drop of insulin to come out of the needle. If it doesn't, repeat this step.

4. Pick a spot.
   

   Make sure the area of skin where you will give the shot is clean. If you use alcohol to clean the skin before you give the injection, let it dry.

   In your third trimester, find a spot on the side of your stomach where you can pinch the skin.

   Or use the thigh, upper arm, or upper buttock.

   Use a different spot each time you inject insulin. Using the same spot every time can cause bumps or pits to form in your skin.

   For example, inject your insulin above your belly button. Then the next time use your upper thigh, and then the next time inject below your belly button.

5. Put it in.
   

   Turn the dose knob to the number of units of insulin that you need to inject.

   Push the needle into your skin. Most people can inject using a 90-degree angle and without pinching the skin.

6. Inject and wait.
   

   Use your thumb to push the injection button until it stops. Keep the pen in your skin. Hold the dose knob in for 10 seconds (or to the number that the manufacturer recommends). Then pull the needle out of your skin. Do not rub the area.

7. Recap the insulin pen.
   

   Put only the outer cap back over the needle. The thin, inner cover is harder to put back on, and you may poke yourself.

8. Throw the needle away.
   

   After covering the needle with the outer cap, unscrew the needle and throw it away in a sharps container or other solid plastic container. You can get a sharps container at your drugstore.

   Don't share insulin pens with anyone else who uses insulin. Even when the needle is changed, an insulin pen can carry bacteria or blood that can make another person sick.

Managing gestational diabetes

• Make healthy food choices.

  Eat plenty of lean protein, fruits, and vegetables. Follow your meal plan to know how much carbohydrate you need for meals and snacks.

• Get regular exercise.

  Try low-impact activities, such as walking and swimming. Try to be active 30 minutes a day, at least 5 days a week.

  If you're increasing your activity, talk to your doctor before you start.

• Check your blood sugar levels.

  Ask your doctor how often to test your blood sugar.

• Get regular checkups.

  Your doctor will do tests to check on you and your baby. You'll talk about your blood sugar levels, eating and staying active, and how to manage pregnancy weight gain.

• Take diabetes medicine or insulin shots if needed.

  This helps control your blood sugar if it can't be managed with healthy eating and regular exercise. Blood sugar can be harder to manage as you approach your due date.