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Questions and Answers
What is the best insulin therapy pattern to achieve euglycemia in pregnancy?
Which basal insulin is the only one approved for use during pregnancy?
How much of the total daily dose (TDD) should be basal insulin in a physiologic administration of insulin during pregnancy?
What can cause hypoglycemia in pregnant women receiving intensive metabolic management?
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What factor significantly increases the risk of preterm birth in women with preexisting diabetes?
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Why do symptoms of hypoglycemia in pregnant women receiving intensive metabolic management change over time?
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What is the recommended pharmacologic therapy for women with type 2 diabetes who become pregnant?
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When do insulin requirements peak throughout pregnancy for women with GDM?
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What is a common issue that women with pregestational diabetes, particularly type 1, are prone to during pregnancy?
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What type of insulin is indicated when meals are inconsistent or delayed during pregnancy?
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What is the recommended action when MNT and exercise do not achieve glycemic control in pregestational diabetes?
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Why should the nurse review the increasing insulin requirements of pregnancy with a woman with diabetes?
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What is the reason behind the maintenance of euglycemia in pregnancy?
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Which fetal growth abnormalities are most frequently seen in women with pregestational or gestational diabetes?
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When should women with gestational diabetes mellitus (GDM) be screened for persistent diabetes postpartum?
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Which trimester is gestational diabetes mellitus (GDM) typically diagnosed?
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What is the recommended testing for high-risk pregnant women regarding gestational diabetes?
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What is the significant concern related to poorly controlled diabetes during pregnancy?
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Study Notes
Insulin Therapy in Pregnancy
- To achieve euglycemia in pregnancy, the best insulin therapy pattern involves a combination of basal, prandial, and correction insulin doses.
- Detemir is the only basal insulin approved for use during pregnancy.
Insulin Dosage in Pregnancy
- In a physiologic administration of insulin during pregnancy, 30-40% of the total daily dose (TDD) should be basal insulin.
Hypoglycemia in Pregnant Women
- Causes of hypoglycemia in pregnant women receiving intensive metabolic management include increased insulin sensitivity, delayed meals, and inadequate carbohydrate intake.
- Symptoms of hypoglycemia in pregnant women change over time due to hormonal fluctuations, which can lead to decreased counterregulatory responses.
Risk Factors in Pregnancy
- A significant factor that increases the risk of preterm birth in women with preexisting diabetes is hypertension.
Pharmacologic Therapy in Pregnancy
- For women with type 2 diabetes who become pregnant, the recommended pharmacologic therapy is a transition to insulin therapy.
Insulin Requirements in Pregnancy
- Insulin requirements peak during the 28th to 32nd weeks of gestation for women with gestational diabetes mellitus (GDM).
Common Issues in Pregnancy
- Women with pregestational diabetes, particularly type 1, are prone to diabetic ketoacidosis during pregnancy.
Insulin Type in Pregnancy
- When meals are inconsistent or delayed during pregnancy, a rapid-acting or short-acting insulin analog is indicated.
Euglycemia Maintenance
- The recommended action when medical nutrition therapy (MNT) and exercise do not achieve glycemic control in pregestational diabetes is to initiate insulin therapy.
- The nurse should review the increasing insulin requirements of pregnancy with a woman with diabetes to prevent maternal and fetal complications.
- The reason behind maintaining euglycemia in pregnancy is to prevent maternal and fetal complications, such as fetal growth abnormalities and congenital anomalies.
Fetal Growth Abnormalities
- Fetal growth abnormalities most frequently seen in women with pregestational or gestational diabetes include macrosomia and intrauterine growth restriction.
Postpartum Screening
- Women with gestational diabetes mellitus (GDM) should be screened for persistent diabetes postpartum at 6-12 weeks after delivery.
Gestational Diabetes Diagnosis
- Gestational diabetes mellitus (GDM) is typically diagnosed during the second trimester, between 24-28 weeks of gestation.
Testing for Gestational Diabetes
- The recommended testing for high-risk pregnant women regarding gestational diabetes is a 1-hour glucose challenge test.
Concerns of Poorly Controlled Diabetes
- The significant concern related to poorly controlled diabetes during pregnancy is an increased risk of maternal and fetal complications, including congenital anomalies, fetal growth abnormalities, and preterm birth.
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Description
Test your knowledge on insulin therapy in pregnancy with questions covering dosage, timing, basal bolus pattern, and types of insulin recommended during pregnancy.
