Insulin dose is determined as follows: Initially: 0 units for a capillary level of < 80 mg / dL (< 4.4 mmol / L) or 0.5 units / hour for a level of 80 to 100 mg / dL (4.4 to 5.5 mmol / L) Thereafter: Increased by 0.5 units / hour for each 40-mg / dL (2.2-mmol / L) increase in glucose level over 100 mg / dL up to 2.5 units / hour for levels > 220 mg / dL (> 12.2 mmol / L) Every hour during labor: Measurement of glucose level at bedside and adjustment of dose to keep the level at 70 to 120 mg / dL (3.8 to 6.6 mmol / L) If the glucose level is significantly elevated: Possibly additional bolus doses For spontaneous labor, the procedure is the same, except that if intermediate-acting insulin was taken in the previous 12 hours, the insulin dose is decreased.