Steroids for accelerating fetal lung maturity are given as either two injections 24 hours apart (betamethasone), or 4-8 injections every 6-12 hours (dexamethasone). The betamethasone regimen is preferred. The maximum benefit for fetal lung maturation is seen 24 hours after the last dose is given and persists for at least 7 days. At present, repetitive dosing is not recommended. Corticosteroids at these doses will adversely affect blood sugar, but adjusting insulin dosage will control this and the fetal benefits tend outweigh the maternal metabolic risks. Blood glucose control will usually return to near baseline levels within 4-5 days.
As for preeclampsia, your wife has two major risk factors - twins, and insulin dependent diabetes, so I suspect that you doctor is correct in his concern regarding preeclampsia development.
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