Pregnant women with diabetes often have problems related to the effectiveness of insulin in controlling their glucose levels during their second half of pregnancy.
The nurse teaches the client that this is due to:
A . Decreased glomerular filtration and increased tubular absorption
B . Decreased estrogen levels
C . Decreased progesterone levels
D . Increased human placental lactogen levels
Answer: D
Explanation:
(A) There is a rise in glomerular filtration rate in the kidneys in conjunction with decreased tubular glucose reabsorption, resulting in glycosuria.
(B) Insulin is inhibited by increased levels of estrogen.
(C) Insulin is inhibited by increased levels of progesterone.
(D) Human placental lactogen levels increase later in pregnancy. This hormonal antagonist reduces insulin’s effectiveness, stimulates lipolysis, and increases the circulation of free fatty acids.
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