- Pregnancy places demands on carbohydrate metabolism and causes insulin requirements to change.
- Maternal glucose crosses the placenta, but insulin does not.
- During the first trimester, maternal insulin needs decrease.
- During the second and third trimesters, increases in placental hormones cause an insulin-resistant state, requiring an increase in the client’s insulin dose.
- After placental delivery, placental hormone levels abruptly decrease and insulin requirements decrease.
- The fetus produces its own insulin and pulls glucose from the mother, which predisposes the mother to hypoglycemic reactions.
- The newborn of a diabetic mother may be large in size, but has functions related to gestational age rather than size.
- The newborn of a diabetic mother is at risk for hypoglycemia, hyperbilirubinemia, respiratory distress syndrome, hypocalcemia, and congenital anomalies.
- Excessive thirst
- Weight loss
- Frequent urination
- Blurred vision
- Recurrent urinary tract infections and vaginal yeast infections
- Glycosuria and ketonuria
- Signs of gestational hypertension
- Large fetus for gestational age