World Health Organization has released global guidelines to support women living with diabetes during pregnancy. The announcement came on World Diabetes Day 2025 and marks a major step toward improving maternal health worldwide.
Diabetes now affects nearly one in six pregnancies, which means close to 21 million women face its risks every year. Without proper care, high blood sugar can lead to complications like preeclampsia, stillbirth, obstructed labour, or dangerously low blood sugar in newborns. The burden is heaviest in low and middle income countries, where access to specialised maternal care is often limited.
The new document includes 27 recommendations that cover the entire pregnancy journey. It aims to meet women where they are, whether they have type 1 diabetes, type 2 diabetes, or develop gestational diabetes during pregnancy. WHO emphasises that every woman’s experience is different, so care must be personalised rather than one size fits all.
A major part of the guideline focuses on lifestyle support. WHO encourages healthcare workers to offer simple, practical advice on healthy eating, physical activity, and safe pregnancy weight gain. The idea is to help women make choices that feel achievable in their daily lives.
Antenatal education plays a key role in this. Women should understand how diabetes affects pregnancy, why blood sugar control matters, and how to monitor glucose at home. They should also learn what to expect during fetal growth checks and why these visits matter for their baby’s health.
For women with type 1 or type 2 diabetes, WHO recommends care from a team of specialists. This may include obstetricians, endocrinologists, midwives, dietitians, and diabetes educators who work together throughout pregnancy. The organisation suggests offering this team based approach to women with gestational diabetes as well, depending on local resources.
The goal is to create an environment where women feel supported rather than overwhelmed.
Blood sugar monitoring remains central to good diabetes management. WHO encourages self monitoring for all pregnant women with diabetes whenever possible. Women with type 1 diabetes benefit most from continuous glucose monitoring, but WHO does not recommend routine continuous monitoring for women with type 2 diabetes or gestational diabetes.
For women with type 1 or type 2 diabetes, an HbA1c test early in pregnancy helps set a safe starting point for care. This test is not routinely needed for gestational diabetes. The guidelines highlight that blood sugar targets should be tailored to each woman’s health needs and circumstances.
Medication choices during pregnancy can feel confusing, and the guideline tries to simplify this. Women with type 1 diabetes should usually stay on the insulin type and delivery method they used before pregnancy unless doctors advise otherwise.
For women with type 2 diabetes, WHO recommends starting metformin or insulin if lifestyle changes are not enough. Women who are already on tablets that are not safe for pregnancy should switch to insulin or metformin. Combination therapy can be used if one medicine alone is not enough.
Women with gestational diabetes can also start with metformin or insulin, and may combine both if needed.
Ultrasound scans
One scan before 24 weeks
One scan in the second trimester
Additional scans after 24 weeks if any concerns arise
Extra fetal monitoring
Women on glucose lowering therapy should receive additional fetal well being checks
Eye screening
Type 1 and type 2 diabetes: eye exam at the start of antenatal care, with follow up based on severity
Gestational diabetes: no routine eye screening needed
Kidney function screening
Type 1 and type 2 diabetes: kidney check early in pregnancy; specialist follow up if impaired
Gestational diabetes: no routine renal screening
Managing kidney issues
Maintain blood pressure below 130 over 80
Provide counselling on reducing cardiovascular risks like smoking and unhealthy diet.
WHO hopes to ensure that mothers and babies receive the safest possible care. With personalized support, regular monitoring, appropriate medication, and integrated antenatal services, millions of women can look forward to healthier and safer pregnancies.
Reference:
1. World Health Organization. WHO Launches Global Guidelines on Diabetes During Pregnancy on World Diabetes Day. November 14, 2025. Accessed November 17, 2025. https://www.who.int/news/item/14-11-2025-who-launches-global-guidelines-on-diabetes-during-pregnancy-on-world-diabetes-day.
(Rh/ARC/MSM)
