Gestational diabetes mellitus and COVID-19: The epidemic during the pandemic

Table 4 Dosing recommendations for insulin and oral agents in management of diabetes during pregnancy

Drug class	Drug	Dosing
	Insulin
Rapid-acting insulin	Insulin lispro	First trimester 0.7 units/kg/d. 14-18 wk 0.8 units/kg/d. 26-27 wk 0.9 units/kg/d. 36-37 wk until delivery 1 unit/kg/d[95]
	Insulin aspart
Short-acting insulin	Regular insulin	First trimester 0.7 units/kg/d. 14-18 wk 0.8 units/kg/d. 26-27 wk 0.9 units/kg/d. 36-37 wk until delivery 1 unit/kg/d[95]
Intermediate-acting insulin	NPH	Two thirds can be given prebreakfast and the remaining one third can be given during the pre-evening meal[95]
Long-acting insulin	Detemir	50% of total daily dose can be given in the pre-evening meal and the remaining 50% can be given as a basal insulin[95]
	Glargine
	Oral agents
Biguanide	Metformin	500 mg once or twice daily with an increase over 1 to 2 wk to a maximum daily dose of 2500 mg. 2000 mg if using metformin of extended release[90,92]
Sulfonylurea	Glyburide	Starting dose of 2.5 to 5 mg once daily with an increase to a maximum dose of 20 mg/d[96]

The table provides dosing information for various drugs in different drug classes used for the treatment of diabetes in pregnancy. The dosing recommendations include different trimesters and specific timeframes until delivery. NPH: Neutral protamine Hagedorn.