Twice the Babies, Twice the Insulin

Type 1 diabetic mothers with twin pregnancies need more insulin than those with singleton pregnancies

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) Insulin medications play a key role in treating type 1 diabetes. Different patients require different doses of insulin. If a diabetic woman is pregnant, how much insulin does she need? What if she has twins?

Type 1 diabetes patients who are pregnant with twins may need higher doses of insulin than patients who are pregnant with one child.

"Get your diabetes under control before getting pregnant."

Diabetes can cause complications in pregnancy. For this reason, it is important for women to get their blood sugar under control before and during pregnancy.

A recent study by Nicoline F. Callesen of the Center for Pregnant Women with Diabetes in Copenhagen, Denmark, and colleagues found that women with type 1 diabetes need different insulin doses during twin pregnancy than during a singleton pregnancy.

Because their body does not make enough insulin, type 1 diabetes patients have to take insulin drugs.

Insulin is a hormone made by the pancreas that helps control levels of sugar in the blood. In people with type 1 diabetes, the pancreas makes little to no insulin, which can send blood sugar levels skyrocketing. If blood sugar gets too high, patients may face a number of health problems.

For their study, Callesen and colleagues compared insulin doses and levels of HbA1c (a measure of blood sugar over time) between 15 women pregnant with twins and 108 women pregnant with a single child.

The insulin requirements of women with twins grew by 103 percent from before pregnancy to 33 weeks. In comparison, there was a 71 percent increase in insulin requirements for women with one child.

Between 14 and 27 weeks of pregnancy, the weekly increase in insulin dose was higher for women with twins than for women with one child. In fact, the weekly increase for twin pregnancies was twice as much as for singleton pregnancies.

The study appears in Diabetes Care, a journal of the American Diabetes Association.

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Review Date: 
May 23, 2012
Last Updated:
August 3, 2012