Question

A client with diabetes visits the prenatal clinic at 28 weeks gestation. Which statement is true regarding insulin needs during pregnancy? A. Insulin requirements moderate as the pregnancy progresses. B. A decreased need for insulin occurs during the second trimester. C. Elevations in human chorionic gonadotrophin decrease the need for insulin. D. Fetal development depends on adequate insulin regulation.

Short answer

A. Insulin requirements moderate as the pregnancy progresses B. A decreased need for insulin occurs during the second trimester C. Elevations in human chorionic gonadotrophin decrease the need for insulin D. Fetal development depends on adequate insulin regulation Answer: D. Fetal development depends on adequate insulin regulation.

Step-by-step solution

Understand the given statements

Read and understand each statement and consider its relevance to insulin needs during pregnancy.

Research insulin needs during pregnancy for diabetic clients

Investigate the changes in insulin requirements throughout the course of a pregnancy, particularly with respect to maternal health and fetal development. Make sure to focus on the second trimester and appropriate gestational age.

Analyze Statement A

"Insulin requirements moderate as the pregnancy progresses": Assess the veracity of this statement based on your research. Does insulin requirement moderate or change in a different way throughout pregnancy?

Analyze Statement B

"A decreased need for insulin occurs during the second trimester": Determine if the information you found supports or contradicts this statement. Is there actually a decrease in insulin needed during the second trimester?

Analyze Statement C

"Elevations in human chorionic gonadotrophin decrease the need for insulin": Evaluate whether this statement is true in relation to insulin needs during pregnancy. Does an increase in human chorionic gonadotrophin impact insulin requirement?

Analyze Statement D

"Fetal development depends on adequate insulin regulation": Reflect on how important proper insulin regulation is for fetal development, particularly in the case of a client with diabetes. Is this statement true?

Determine the correct statement

Compare your analysis of each statement to identify the true statement regarding insulin needs during pregnancy for a client with diabetes visiting the prenatal clinic at 28 weeks gestation. Based on the analysis above, the correct answer is: D. Fetal development depends on adequate insulin regulation.

Key concepts

Prenatal Clinic Care

Prenatal clinic care encompasses a spectrum of health services provided to pregnant women to ensure maternal and fetal health during pregnancy. During routine visits, healthcare providers monitor the growth and development of the fetus and the health of the mother. For those with pre-existing conditions such as diabetes, these clinic visits become critical for managing health complications.

Special attention is given to monitoring blood glucose levels and adjusting treatment plans as necessary. This involves regular screening for gestational diabetes, education regarding diet and exercise, and providing psychosocial support. Women with diabetes should expect frequent consultations to ensure that both the mother's and the baby's needs are met throughout the pregnancy.

Diabetes Management in Pregnancy

Managing diabetes during pregnancy is paramount since uncontrolled blood glucose levels can have serious implications for both mother and baby. Treatment plans often include dietary modifications, exercise, blood glucose monitoring, and may require medication or insulin therapy.

For a pregnant woman with pre-existing diabetes, managing her condition requires a delicate balance to protect fetal development while also keeping her blood glucose levels within a target range. A healthcare provider may adjust her insulin regimen as the placenta produces hormones that can cause insulin resistance, particularly in the second and third trimesters. Continuous monitoring helps in making timely adjustments to insulin dosages.

Gestational Insulin Regulation

During pregnancy, hormonal changes can lead to what is known as insulin resistance, necessitating adjustments in insulin management for women with diabetes. Typically, insulin resistance heightens during the second and third trimesters, often resulting in an increased need for insulin.

In contrast to Statement B from the exercise, a woman may actually require more insulin during this time to maintain glycemic control. Contrary to Statement C, increases in human chorionic gonadotropin (HCG) do not directly decrease the need for insulin. Insulin needs are more closely linked to placental hormones like human placental lactogen and progesterone.

Fetal Development

Proper fetal development is intricately linked to the maternal environment, including glucose levels regulated by insulin. If the mother's blood glucose levels are high due to inadequate insulin regulation, the excess sugar can cross the placenta. This results in the fetus producing more insulin, leading to macrosomia (larger than average birth weight) and associated complications.

Therefore, maintaining adequate insulin regulation, as mentioned in the correct answer, Statement D, is essential for preventing complications and promoting healthy fetal development. This requires a careful, individualized approach to insulin therapy during pregnancy.