On this year’s World Diabetes Day (14 November), the World Health Organization (WHO) released its first global guidelines dedicated solely to managing diabetes during pregnancy, closing a major gap in maternal and newborn care.
Diabetes now affects about one in six pregnancies worldwide – roughly 21 million women every year – including those with pre-existing type 1 or type 2 diabetes and those who develop gestational diabetes.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said the new guidance brings together what used to be fragmented advice on pregnancy and diabetes into a single standard of care that “reflects the realities of women’s lives and health needs” and is meant to be used “for every woman, everywhere.”
27 recommendations for safer pregnancies
The guideline sets out 27 evidence-based recommendations covering detection, monitoring and treatment. They stress:
- Individualised care plans for women with type 1, type 2 or gestational diabetes
- Regular blood glucose monitoring, including self-monitoring at home and clinic checks, with continuous glucose monitoring recommended where feasible for type 1 diabetes
- Clear glycaemic targets tailored to each woman’s health and pregnancy
- Thoughtful use of insulin and metformin when lifestyle changes alone are not enough
- Multidisciplinary, specialised teams for women entering pregnancy with pre-existing diabetes
The guidance also calls for routine ultrasound scans and additional fetal monitoring when medication is needed, along with screening for diabetes-related eye and kidney disease in pregnant women with long-standing diabetes.
Poorly controlled diabetes in pregnancy sharply increases the risk of pre-eclampsia, stillbirth, birth trauma and newborn complications. It also raises the long-term odds of type 2 diabetes and cardiometabolic disease for both mother and child, with the heaviest burden falling on low- and middle-income countries, where specialist services and technology are often scarce.
A central message of the new guideline is that diabetes care must be fully integrated into routine antenatal services, rather than treated as a niche specialty. WHO urges countries to prioritise access to essential tests, insulin, metformin and basic monitoring tools at primary-care level, and to ensure postnatal follow-up so women are screened and supported after delivery.
Diabetes across life stages
The guideline launch coincides with WHO’s World Diabetes Day 2025 theme, “Diabetes across life stages”, which emphasises that people with diabetes – from childhood through older age – need continuous, coordinated care and supportive policies to live well.
Globally, more than 800 million adults now live with diabetes, four times the number recorded in 1990, with the fastest growth in low- and middle-income countries. Diabetes is already a leading cause of heart disease, kidney failure, blindness and limb amputation; WHO and partners say scaling up prevention, early diagnosis and guideline-based care – including during pregnancy – is critical to ensuring that “no one is left behind.”
