In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy,the nurse recognizes that further teaching is warranted when the client states:
A)"I will need to increase my insulin dosage during the first 3 months of pregnancy."
B)"Insulin dosage will likely need to be increased during the second and third trimesters."
C)"Episodes of hypoglycemia are more likely to occur during the first 3 months."
D)"Insulin needs should return to normal within 7 to 10 days after birth if I am bottle feeding."

Question

Quizplus · Accepted Answer

Insulin needs are reduced in the first trimester due to increased insulin production by the pancreas and increased peripheral sensitivity to insulin.Insulin resistance begins as early as 14 to 16 weeks of gestation and continues to rise until it stabilizes during the last few weeks of pregnancy.During the first trimester maternal blood glucose levels are reduced and the insulin response to glucose is enhanced;therefore,this is when an episode of hypoglycemia is most likely to occur.For the nonbreastfeeding mother insulin levels return to normal within 7 to 10 days.Lactation uses maternal glucose;therefore,the mother's insulin requirements remain low during lactation.On completion of weaning the mother's prepregnancy insulin requirement is reestablished.

In Assessing the Knowledge of a Pregestational Woman with Type