Once-Daily vs Twice-Daily Insulin Glargine in Pregestational Diabetes Management

Inclusion Criteria: * Patients older than 18 years of age; * The patient is fluent in English, physically and mentally able to understand the informed consent, and is willing to participate in this study; * Type II diabetes mellitus requiring insulin; * The patient is between 24 weeks 0 days and 28 weeks 0 days of gestation at the time of enrollment. Gestational age will be determined by last menstrual period, confirmed with a first trimester ultrasound, per the recommended guidelines by the American College of Obstetricians and Gynecologists. * Currently using or willing to use a clinically indicated continuous glucose monitor for glycemic management Exclusion Criteria: * Known allergy or reaction to insulin glargine, or concurrent medical condition where the use of insulin glargine is contraindicated; * Contraindication to CGM use, patient declines CGM use, or CGM not covered by patient's insurance; * Concomitant use of other anti-diabetic medication (such as metformin); use of a short-acting insulin will not be considered an exclusion; * Known or suspected fetal anomaly or aneuploidy; * Prisoners; * Ongoing prenatal care outside EVMS or planned delivery outside Sentara Norfolk General Hospital.