Insulin dose calculation in pregnancy from TOGIVEL Obstetrics and Gynecology textbook

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3. Pharmacotherapy: INSULIN & HYPOGLYCEMIC AGENTS
Insulin dose calculation in pregnancy:
Initial dosing
Adjusting dose according to blood glucose monitoring
The “initial” total daily insulin requirement in pregnant women with type 1 diabetes is
0.7 units/kg current weight in the first trimester, often increasing to
0.8 units/kg current weight for weeks 13 to 28,
0.9 units/kg current weight for weeks 29 to 34, and
1.0 units/kg current weight for weeks 35 to term;
1. Multiple daily injection regimen
50 percent of the total insulin dose is administered as a rapid acting insulin before each meal
50 percent is administered as an intermediate insulin (NPH) twice daily:
First dose before breakfast
Second dose is given either before dinner with a rapid-acting insulin or at bedtime, whichever works best for avoiding nocturnal hypoglycemia.
2. Two injections regimen:
Two third total insulin dose is administered Prebreakfast 7.00 am as
1/3 Rapid acting Insulin
2/3 NPH
One third total insulin dose is administered afternoon 5.00 pm as
1/3 Rapid acting Insulin
2/3 NPH
Two injections regimen rarely achieve glucose and A1C goals and can cause nocturnal hypoglycemia from intermediate-acting insulin given at dinner time.

In both regimens: This is not the final dose, this is only the dose to start with (initial dose) then dosing is continuously adjusted based on self-monitoring of blood glucose and A1C values.
3. Continuous subcutaneous insulin infusion (CSII; also known as insulin pump therapy) benefit to pregnant women with insulin-treated diabetes who:
Are using multiple daily injections of insulin and
Do not achieve blood glucose control.