Final answer:
A primigravida client with type 1 diabetes would typically expect to increase her insulin dosage between the 16th and 18th weeks of gestation. Insulin resistance increases during pregnancy due to placental hormones, necessitating higher insulin doses until delivery, after which the need rapidly declines.
Step-by-step explanation:
When a primigravida client with type 1 diabetes is educated on the changes in insulin needs during pregnancy, a notable increase is typically expected. During pregnancy, insulin resistance tends to increase due to the anti-insulin hormones produced by the placenta. Consequently, insulin dose adjustments are necessary.
During the first trimester, some women might experience a decrease in insulin requirements due to nausea and vomiting affecting their food intake. However, between the 16th and 18th weeks of gestation, and extending into the third trimester, insulin needs generally increase substantially. This period coincides with a rapid phase of fetal growth and increased hormonal levels that counteract insulin.
After delivery, insulin requirements rapidly decline and often return to pre-pregnancy levels or even lower immediately postpartum. This is due to the absence of placental hormones and the reduction of insulin resistance. It is critical for women with type 1 diabetes to closely monitor their glucose levels and work with their healthcare provider to adjust their insulin dosage accordingly throughout their pregnancy and after birth to maintain good glycemic control.