Metabolic changes throughout pregnancy affecting glucose and insulin in the mother and the fetus are complicated but important to understand. Nurses should know that:
1. insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own.
2. women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester because they are consuming more sugar.
3. during the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.
4. maternal insulin requirements steadily decline during pregnancy.
3
1. Incorrect. Insulin never crosses the placenta; the fetus starts making its own around the 10th week.
2. Incorrect. As a result of normal metabolic changes during pregnancy, insulin-dependent women are prone to hypoglycemia (low levels).
3. Correct. Pregnant women during the second and third trimesters develop increased insu-lin resistance.
4. Incorrect. Maternal insulin requirements may double or quadruple by the end of preg-nancy.
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