7.4.0.0 Preexis­ting Type 1 and Type 2 Di­a­betes

In­sulin sen­si­tiv­i­ty in­creases dra­mat­i­cal­ly with de­liv­ery of the pla­cen­ta. Thus, in­sulin re­quire­ments in the im­me­di­ate post­par­tum pe­ri­od are rough­ly 34% lower than prepreg­nan­cy in­sulin re­quire­ments (87). In­sulin sen­si­tiv­i­ty then re­turns to prepreg­nan­cy lev­els over the fol­lowing 1–2 weeks. In women tak­ing in­sulin, par­tic­u­lar at­ten­tion should be di­rect­ed to hy­po­glycemia pre­vention in the set­ting of breast­feed­ing and er­rat­ic sleep and eat­ing sched­ules (88).