Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is true regarding insulin requirements during pregnancy?

1. They are lower in women with higher body weight.

2. They increase dramatically after delivery.

3. They increase progressively throughout gestation.

4. They are increased during the first trimester.

The correct answer is: They increase progressively throughout gestation.

During pregnancy, insulin requirements generally increase progressively throughout gestation. This phenomenon can be attributed to several physiological changes that occur as the pregnancy advances. As the placenta develops, it produces hormones such as human placental lactogen and progesterone, which can lead to insulin resistance. This increased resistance necessitates higher doses of insulin to maintain blood glucose levels within the target range. Beginning in the second trimester, the demand for insulin rises increasingly, with the most significant changes observed in the later stages of pregnancy. This progressive increase is critical in ensuring that the developing fetus has an adequate supply of glucose while also maintaining the mother’s health. While insulin requirements can indeed vary based on individual factors, such as weight and overall health, the overarching trend is the progressive increase throughout gestation, making this statement true.