Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?

• A. 10th and 12th weeks of gestation
• B. 18th and 22nd weeks of gestation
• C. 24th and 28th weeks of gestation
• D. 36th and 40th weeks of gestation

Answer: (C)

Insulin needs rise in pregnancy because placental hormones (like human placental lactogen) create insulin resistance in the mother. In early pregnancy, insulin requirements are often similar to pre-pregnancy or only slightly lower, but as the placenta grows, resistance increases and insulin doses typically must be increased. The shift toward higher requirements tends to start in the second half of pregnancy, with noticeable increases beginning around mid-pregnancy. The window around 24–28 weeks is when these needs commonly start to rise, and they continue to increase into the late second and third trimesters toward delivery. So, around 24–28 weeks is when a client with type 1 diabetes would expect to begin increasing her insulin dosage.