Which of the following is a risk factor for increased insulin requirements during pregnancy?

Increased insulin requirements during pregnancy can be significantly influenced by various factors, particularly pre-existing conditions. Long-standing diabetes mellitus is indeed a risk factor for this scenario. When a woman has diabetes prior to pregnancy, her body may already have altered insulin sensitivity and secretion capabilities. During pregnancy, physiological changes happen that may require the body to produce more insulin to maintain blood glucose levels, especially during a time when insulin resistance increases due to placental hormones.

As a result, women with a history of long-standing diabetes often find that their insulin requirements escalate during pregnancy. This is due to a combination of their baseline insulin resistance and the additional demands placed on the body during gestation.

Other factors like obesity, gestational diabetes, and multiple pregnancies do also contribute to increased insulin needs; however, the pre-existing complications associated with long-standing diabetes mellitus make it a primary concern in managing insulin requirements during pregnancy. Thus, understanding the nuances of how long-standing diabetes can affect insulin management is crucial for midwifery and obstetrics practice.