WHO Guidelines: Diabetes & Pregnancy – Global Recommendations

The World Health Organization (WHO) has issued its first global guidelines for managing diabetes during pregnancy, a condition affecting approximately one in six pregnancies – or 21 million women annually. Released on November 14, 2025, these recommendations aim to address a growing health challenge and mitigate serious complications for both mothers and their children. The guidelines provide a standardized approach to care, particularly crucial in low- and middle-income countries where access to specialized resources is often limited.

Understanding the Risks of Diabetes in Pregnancy

Diabetes during pregnancy, if not effectively managed, significantly elevates the risk of life-threatening conditions like pre-eclampsia (a pregnancy complication characterized by high blood pressure and organ damage), stillbirth, and birth injuries. Beyond immediate risks, both mothers and children face long-term consequences, including an increased lifetime risk of type 2 diabetes and cardiometabolic diseases. These guidelines represent a significant step towards reducing these risks globally.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, emphasized the importance of this specific guidance, stating that while the WHO has previously offered advice on both diabetes and pregnancy, this is the first time a dedicated standard of care for managing diabetes during pregnancy has been established. The guidelines are designed to be practical and adaptable to diverse healthcare settings and women’s needs. You can find more information about the guidelines on the WHO news page.

Key Recommendations for Comprehensive Care

The WHO guidelines encompass 27 key recommendations, focusing on individualized, optimal, and personalized care. A core principle is individualized care, with advice tailored to each woman’s needs regarding diet, physical activity, and blood sugar targets. Regular blood glucose monitoring is similarly emphasized – both during clinic visits and at home – to ensure effective management.

Treatment approaches are also personalized, with specific medication regimens recommended for women with type 1 diabetes, type 2 diabetes, and gestational diabetes when pharmacological intervention is necessary. For women with pre-existing diabetes, the guidelines advocate for multidisciplinary care, bringing together a team of specialists to provide comprehensive support. The full recommendations are available in the WHO publication.

Who Benefits from These Guidelines?

These guidelines are intended for a broad audience, including policymakers and healthcare providers responsible for developing national and local healthcare protocols. Directly, they are aimed at those providing care to pregnant women, such as obstetricians, midwives, endocrinologists, nurses, general practitioners, dietitians, and diabetes educators. The guidelines are also designed to be useful for training health workers and strengthening health systems to improve clinical care delivery. Non-governmental organizations focused on maternal care and maternal and child health program implementers will also find the guidance valuable.

The Scope of Diabetes in Pregnancy: A Global Challenge

The WHO estimates that approximately one in six pregnancies – equivalent to 21 million women annually – are affected by diabetes. While the guidelines are globally applicable, the burden of diabetes in pregnancy is disproportionately high in low- and middle-income countries. This is often due to limited access to specialized care and resources, creating a critical necessitate for effective and accessible management strategies. The guidelines aim to bridge this gap by providing evidence-based strategies that can be adapted to various resource settings.

Evidence Base and Considerations

The WHO guidelines are grounded in the best available evidence, synthesizing research on diabetes and pregnancy to create a practical standard of care. However, it’s important to acknowledge that research in this area can be complex. Studies may vary in design, population, and methodology, which can influence the strength of the evidence. The guidelines represent a consensus based on the current understanding, but ongoing research is crucial to refine and improve these recommendations over time. The WHO’s Human Reproduction Programme (HRP) played a key role in developing these recommendations, as noted in the WHO document.

What’s Next: Implementation and Ongoing Evaluation

The release of these guidelines is just the first step. Successful implementation will require collaboration between national governments, healthcare providers, and international organizations. This includes integrating the guidelines into national healthcare policies, training healthcare workers, and ensuring access to essential medications and monitoring equipment.

The WHO will continue to monitor the impact of these guidelines and update them as latest evidence emerges. Regular reviews of the evidence base will be conducted to ensure that the recommendations remain current and effective. Surveillance systems will also be strengthened to track the prevalence of diabetes in pregnancy and assess the effectiveness of interventions.

Further research is needed to address specific gaps in knowledge, such as the optimal management of diabetes in pregnancy in different cultural contexts and the long-term health outcomes for mothers and children affected by gestational diabetes. Continued investment in research and innovation will be essential to improve the care of women with diabetes during pregnancy and reduce the global burden of this condition.