What is the total daily insulin dose (TDI) recommended for a pregnant individual under 13 weeks of gestation?

The recommended total daily insulin dose (TDI) for a pregnant individual under 13 weeks of gestation is 0.7 units/kg. This dosage is aligned with the physiological changes and insulin requirements during early pregnancy. In the first trimester, women typically experience lower insulin needs compared to later stages of pregnancy, primarily due to lower levels of hormones that increase insulin resistance, such as progesterone and human placental lactogen, which become more significant later on.

By calculating the insulin needs based on body weight, providers can personalize treatment for gestational diabetes or diabetes mellitus in pregnant individuals, ensuring they receive the appropriate amount of insulin while minimizing risks for both the mother and fetus. As gestation progresses, insulin requirements tend to increase significantly, so the initial dosage of 0.7 units/kg serves as a guideline for early management in pregnancy.