Type 1 and Pregnant with Twins: Your Insulin Needs
Obstetricians and gynecologists agree: carrying multiple babies can mean more complications. Studies have found that women pregnant with two or more babies have a greater risk of gestational diabetes, preeclampsia, and even postpartum depression.
So what happens when those risks are combined with type 1 diabetes?
In a study published in Diabetes Care, researchers sought to find out how women with type 1 diabetes respond to twin pregnancy. They conducted tests on 15 women pregnant with twins and 108 women pregnant with a single infant, testing their HbA1c, blood pressure, and insulin dose at weeks 8, 14, 21, 27, and 33.
So, what did they find? According to the American Diabetes Association:
“This study documented a doubling of the weekly increase in total insulin requirement between 14 and 27 gestational weeks in twin pregnancies as compared with singleton pregnancies in women with type 1 diabetes.”
While the A1c of the two groups of women remained similar throughout the testing period, the research did reveal a dramatic increase in the amount of insulin a woman carrying twins will need. The women carrying a single baby needed, on average, 1.5 units of insulin per day; those carrying twins, by contrast, needed 3. This increase in insulin requirement seemed constant until after week 33 of pregnancy.
As with any other study, it is important that we look at the limitations before we take every conclusion to heart. This research was uncovered from a very small sample size, and as the researchers admitted in their report, “Data on insulin dose after 33 weeks were not available for the twin pregnancies due to high rate of preterm delivery.”
So, is there cause for concern if you are pregnant with twins? Not exactly. But there is cause for keeping a close eye on your insulin needs as your pregnancy progress. Talk to your doctors and family members, and be diligent in monitoring your health. After all, it's about all three of you!