Diabetes now affects 1 in 6 pregnancies: WHO recommendations on risks, challenges, and management

Diabetes, especially type 2 diabetes, is one of the most unnerving diseases in the world, with nearly 600 million victims of it — partly because of the toll it takes on the patient, partly because the disease comes with no substantial cure.

Diabetes is a chronic disease where the body either doesn't produce enough insulin, a hormone that helps glucose enter cells, or it doesn't use insulin effectively (insulin resistance). This leads to high blood sugar levels, as too much glucose stays in the blood and not enough reaches the cells for energy. As of 2025, an estimated 589 million adults are living with diabetes worldwide, representing 1 in 9 adults aged 20-79 years, according to the 11th edition of the IDF Diabetes Atlas. If that’s not concerning enough, diabetes is now affecting more pregnant women than ever — about one in six pregnancies worldwide now involves elevated blood sugar levels, with a staggering figure that translates to around 21 million women each year, according to the World Health Organization (WHO).

On World Diabetes Day 2025, the WHO released its first-ever global guidelines for managing diabetes during pregnancy — the aim being to reduce serious risks to both mother and child, especially in low- and middle-income countries where access to care may be limited.

Want to know more? Read on.

Hyperglycaemia (high blood sugar) during pregnancy can take several forms: women may already have type 1 or type 2 diabetes before conceiving, or they may develop gestational diabetes mellitus (GDM) for the first time during pregnancy. Without proper management, diabetes in pregnancy can trigger life-threatening complications, such as pre-eclampsia, stillbirth, and birth injuries.

Moreover, long-term risks loom larger than just the inconvenience during the pregnancy — the mothers are more likely to develop type 2 diabetes later in life, while their children face a greater chance of obesity, cardiovascular disease, and metabolic disorders.

To tackle this growing crisis, the World Health Organization’s guidelines lay out 27 detailed recommendations covering the entire pregnancy journey — from preconception to the postnatal period. Here are some of the most important ones:

Individualized care: This one perhaps is the most crucial one for women going through pregnancy: advice on a healthy diet, physical activity, and blood sugar targets should be tailored to each woman’s type of diabetes — whether it’s type 1, type 2, or GDM.

Regular glucose monitoring: The WHO stresses that pregnant women with diabetes should check their blood sugar not only in clinics, but also at home.

Medication when needed: If lifestyle measures alone don’t control blood sugar, the WHO recommends starting medications. The guidelines provide specific protocols for insulin or other therapies depending on the type of diabetes.

Multidisciplinary support: Pregnant women with pre-existing diabetes should receive care from a team — including endocrinologists, obstetricians, nurses, and dietitians — to monitor complications and adjust treatment. For example, a diet low in added sugars and rich in whole grains, fruits, vegetables, and legumes is strongly advised, based on their needs and conditions.

Long-term follow-up: It’s not just the duration of the pregnancy — after delivering the baby, it’s of vital importance that women and their children are monitored over time, since the risk of developing type 2 diabetes remains high.

The highest burden of diabetes in pregnancy is in low- and middle-income countries, where health systems may lack resources for regular screening, monitoring, and treatment. So, it’s important to pay close attention to those women and the lifestyle they should be adhering to.

However, it’s also important to note that maintaining a healthy diet and consistent physical activity is hard where nutritious food, safe exercise spaces, or patient education may be limited.

In addition, many women may not know they have diabetes before getting pregnant. Besides, some women, especially in resource-limited settings, may be reluctant to use insulin or other drugs during pregnancy due to cost, fear, or lack of medical support. To tackle that, the WHO notes that early screening, consultation, and proper guidance are critical; however, considerable gaps persist in many places.

Hyperglycaemia during pregnancy demands a different approach from diabetes outside pregnancy, because of the impacts on both mother and baby. Hence, women should have access to healthcare professionals who are well-equipped to handle that.

Diet and nutrition: WHO recommends a balanced diet low in added sugar, focusing on whole grains, vegetables, fruits, and pulses.

Physical activity: At least 150 minutes of moderate exercise per week is advised, including resistance training, as long as it’s safe for the pregnancy.

Ultrasound scanning: Routine ultrasounds before 24 weeks and again after 24 weeks are recommended to monitor fetal growth and detect abnormalities.

Medication decisions: If blood sugar is not well-controlled through diet and activity, one may need to get started with medication, including insulin.

This is the first time WHO has offered a standardized, global set of recommendations just for diabetes in pregnancy. Until now, many countries have lacked unified guidance, especially those with fewer resources.

By integrating diabetes care into routine antenatal services, the guidelines aim to make early testing, regular follow-up, and essential treatments more accessible — even in remote or underserved areas. This could prevent thousands of dangerous pregnancy complications and reduce long-term health risks for mothers and babies.