Diabetes, particularly type 2 diabetes, remains a formidable global health challenge, affecting nearly 600 million individuals worldwide. This chronic disease not only places a significant burden on patients but also lacks a definitive cure. As of 2025, approximately 589 million adults, or one in nine adults aged 20-79, are living with diabetes, according to the 11th edition of the IDF Diabetes Atlas.
More concerning, however, is the rise in diabetes cases among pregnant women. The World Health Organization (WHO) reports that one in six pregnancies worldwide now involves elevated blood sugar levels, impacting around 21 million women annually. On World Diabetes Day 2025, the WHO unveiled its first-ever global guidelines to manage diabetes during pregnancy, aiming to mitigate serious risks to both mothers and their children, particularly in low- and middle-income countries where healthcare access is often limited.
Understanding Diabetes in Pregnancy
Diabetes during pregnancy can manifest in various forms. Some women may enter pregnancy with pre-existing type 1 or type 2 diabetes, while others develop gestational diabetes mellitus (GDM) for the first time during pregnancy. Without appropriate management, these conditions can lead to severe complications, including pre-eclampsia, stillbirth, and birth injuries.
Beyond the immediate pregnancy-related risks, long-term health concerns are significant. Mothers are at an increased risk of developing type 2 diabetes later in life, and their children face heightened chances of obesity, cardiovascular disease, and metabolic disorders.
WHO’s Comprehensive Guidelines
To address this growing crisis, the WHO has outlined 27 detailed recommendations that span the entire pregnancy journey, from preconception to the postnatal period. Key recommendations include:
Individualized Care
One of the most crucial aspects for pregnant women is receiving personalized advice on a healthy diet, physical activity, and blood sugar targets, tailored to their specific type of diabetes—whether type 1, type 2, or GDM.
Regular Glucose Monitoring
The WHO emphasizes the importance of regular glucose monitoring for pregnant women with diabetes, both in clinical settings and at home, to ensure optimal blood sugar control.
Medication When Necessary
If lifestyle interventions alone are insufficient, the WHO recommends initiating medication. The guidelines provide specific protocols for insulin or other therapies, depending on the type of diabetes.
Multidisciplinary Support
Women with pre-existing diabetes should receive care from a multidisciplinary team, including endocrinologists, obstetricians, nurses, and dietitians, to monitor complications and adjust treatment plans. A diet low in added sugars and rich in whole grains, fruits, vegetables, and legumes is strongly advised, based on individual needs and conditions.
Long-Term Follow-Up
Post-pregnancy monitoring is vital, as the risk of developing type 2 diabetes remains high for both mothers and their children. Continuous follow-up can help manage and mitigate these risks.
Challenges in Low- and Middle-Income Countries
The burden of diabetes during pregnancy is particularly high in low- and middle-income countries, where healthcare systems may lack the resources for regular screening, monitoring, and treatment. Women in these regions often face additional barriers, such as limited access to nutritious food, safe exercise spaces, and patient education.
Moreover, many women may not be aware of their diabetes status before pregnancy. In resource-limited settings, there may be reluctance to use insulin or other medications due to cost, fear, or lack of medical support. The WHO underscores the importance of early screening, consultation, and proper guidance, though significant gaps persist in many areas.
Looking Ahead
Hyperglycemia during pregnancy requires a distinct approach compared to diabetes outside of pregnancy, given its dual impact on both mother and child. Access to healthcare professionals equipped to manage these unique challenges is essential. As the WHO’s guidelines are implemented, they offer a pathway to better health outcomes for millions of women and their families worldwide.
Moving forward, the global health community must focus on bridging the gap in healthcare access and education, particularly in underserved regions, to ensure that all women receive the care they need during this critical period.
