Does medication need to be modified?

The following notes include instructions on management of insulin therapy in preconceptional period. According to the following, consider possible changes that should be performed or not:

• R 1.3a Insulin-treated women seeking to conceive should be treated with multiple daily doses and continuous subcutaneous (sc) insulin infusion in preference to split-dose, pre-mixed insulin therapy. (1++)

• R 1.3b Changes made to insulin regimen, should be seriously considered before withdrawing contraceptive measures or otherwise start trying to conceive. Particularly, if continuous sc insulin infusion is initiated, first be sure the patient has acquired expertise and been optimized with the chosen insulin regimen. (ungraded)

• R 1.3c If insulin therapy used, prefer rapid-acting analog to regular. (2++)

• R 1.3d If long-acting insulin analogs are successfully used, such as detemir or glargine, may be continued before and during pregnancy -though glargine is not yet approved by Food and Drug Association (FDA). (2++)

Is modification of medication needed, based on the previous notes?