Inclusion Criteria:  Inclusion criteria will include pregnant women with pre-existing T2DM and GDM who requiring insulin to manage their blood sugars in pregnancy.  Exclusion Criteria:  Multiple Gestation Type 1 Diabetes mellatus Age < 18 Known or suspected hypersensitivity to NPH or insulin detemir Known fetal major malformations Chronic renal or hepatic insufficiency Known to be HIV, Hepatitis B, or Hepatitis C positive Indication for planned premature delivery (placenta accrete, or prior classical cesarean delivery) Insulin dependent before conception