Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What happens to insulin requirements as pregnancy progresses?

1. They remain stable throughout the pregnancy.

2. They decrease after the third trimester.

3. They fluctuate widely.

4. They increase progressively.

The correct answer is: They increase progressively.

As pregnancy progresses, insulin requirements typically increase progressively due to hormonal changes that affect carbohydrate metabolism. During pregnancy, the body becomes more insulin-resistant as a result of placental hormones such as progesterone, estrogen, and human placental lactogen. This insulin resistance necessitates higher levels of insulin to maintain glycemic control. In the first trimester, some women may find that their insulin needs decrease initially due to changes in metabolism, but as the pregnancy advances, particularly in the second and third trimesters, the demand for insulin increases significantly. This is crucial for supporting fetal growth and managing maternal blood glucose levels effectively. Understanding this trend is vital for effective diabetes management during pregnancy, particularly for women with pre-existing diabetes or gestational diabetes. Recognizing the progressive increase in insulin requirements helps healthcare providers tailor treatment plans to ensure both maternal and fetal health throughout pregnancy.