Based on the World Health Organization (WHO) publication: WHO Recommendations on Care for Women with Diabetes During Pregnancy (2025).
Managing diabetes during pregnancy requires more than routine prenatal care. Whether a woman enters pregnancy with Type 1 Diabetes, Type 2 Diabetes, or develops Gestational Diabetes Mellitus (GDM), effective management is essential for protecting both maternal and baby health.
In 2025, the World Health Organization (WHO) released its first comprehensive guideline dedicated specifically to the care of women with diabetes during pregnancy. The recommendations cover nutrition, glucose monitoring, medication management, fetal monitoring, and long-term maternal health.
If you are newly diagnosed with gestational diabetes, you may also find our guide helpful: Gestational Diabetes & Pregnancy Resource Center.
Why Diabetes During Pregnancy Matters
According to WHO, approximately 830 million adults were living with diabetes globally in 2022, and around one in six live births is affected by diabetes during pregnancy.
Diabetes in pregnancy may occur as:
- Type 1 Diabetes
- Type 2 Diabetes
- Gestational Diabetes Mellitus (GDM)
Pregnancy complicated by diabetes increases the risk of:
For Mothers
- Pre-eclampsia
- Pregnancy-related hypertension
- Caesarean birth
- Future Type 2 Diabetes risk
For Babies
- Stillbirth
- Macrosomia (larger-than-average baby)
- Birth injury
- Neonatal hypoglycaemia
- Congenital anomalies
- Long-term metabolic health risks
Learn more about the broader relationship between women and diabetes in our Women & Diabetes Knowledge Hub.
The Four Foundations of Diabetes Care During Pregnancy
1. Personalized Nutrition, Physical Activity and Weight Management
WHO recommends individualized advice on diet, physical activity and healthy gestational weight gain for women with Type 1, Type 2 and Gestational Diabetes.
Key Dietary Principles
- Whole grains, vegetables, fruits and legumes
- At least 400g vegetables daily
- Approximately 25g fibre daily
- Reduced saturated and trans fats
- Limited free sugar intake
Physical Activity Recommendations
- 150 minutes of moderate-intensity activity weekly
- Strength and flexibility exercises
- Continuation of pre-pregnancy exercise routines when medically appropriate
2. Diabetes-Specific Antenatal Education
WHO recommends structured education covering:
- Effects of diabetes on pregnancy
- Nutrition and exercise
- Blood glucose management
- Weight gain expectations
- Fetal monitoring requirements
3. Multidisciplinary Specialized Care
Women with pre-existing Type 1 or Type 2 Diabetes should ideally receive care from a multidisciplinary team.
- Obstetrician
- Endocrinologist
- Diabetes educator
- Dietitian
- Specialist nurse
- Mental health professional
- Exercise specialist
4. Individualized Blood Glucose Targets
WHO advises against a one-size-fits-all glucose target. Targets should be individualized according to:
- Type of diabetes
- Hypoglycaemia risk
- Comorbidities
- Available monitoring resources
- Personal preferences and circumstances
Blood Glucose Monitoring During Pregnancy
Self-Monitoring of Blood Glucose (SMBG)
WHO recommends SMBG for women with Type 1, Type 2 and Gestational Diabetes whenever feasible.
Continuous Glucose Monitoring (CGM)
CGM is recommended for women with Type 1 Diabetes where available.
Potential benefits include:
- More time within target glucose range
- Reduced neonatal intensive care admissions
- Improved maternal confidence and satisfaction
Medication Recommendations
Type 1 Diabetes
WHO recommends continuing pre-pregnancy insulin therapy unless changes are needed to improve outcomes.
Type 2 Diabetes
If lifestyle measures alone are insufficient, WHO recommends:
- Metformin
- Insulin
Gestational Diabetes
When diet and physical activity are insufficient:
- Metformin may be considered
- Insulin may be initiated
- Combination therapy may be required in some women
Additional Monitoring for Mother and Baby
Fetal Monitoring
- Routine ultrasound before 24 weeks
- Additional growth scans where indicated
- Enhanced fetal surveillance when medication is required
Eye Health (Retinopathy Screening)
Women with Type 1 or Type 2 Diabetes should receive retinal screening early in pregnancy.
Kidney Health (Renal Assessment)
Women with Type 1 or Type 2 Diabetes should undergo renal function assessment at the beginning of pregnancy.
A Life-Course Approach to Women's Health
WHO emphasizes that diabetes care should continue beyond childbirth. Women with a history of Gestational Diabetes face a substantially higher future risk of Type 2 Diabetes and cardiovascular disease.
Long-term follow-up, healthy lifestyle habits, and regular metabolic screening are therefore essential.
Key Takeaway
The 2025 WHO recommendations highlight the importance of personalized care, informed decision-making, specialist support, and evidence-based monitoring throughout pregnancy.
For women living with Type 1 Diabetes, Type 2 Diabetes, or Gestational Diabetes, early intervention and consistent management can dramatically improve outcomes for both mother and baby.
Explore additional resources:
Source & Attribution
This article is an independent educational summary prepared by Diafemme based on recommendations published by the World Health Organization (WHO). The original data, recommendations, and evidence assessments remain the intellectual work of the World Health Organization.
Primary Reference
World Health Organization (WHO). WHO Recommendations on Care for Women with Diabetes During Pregnancy. Geneva: World Health Organization; 2025. ISBN: 978-92-4-011704-4.
World Health Organization. WHO recommendations on care for women with diabetes during pregnancy. Geneva: WHO; 2025. Licence: CC BY-NC-SA 3.0 IGO.
How to Cite This Source
World Health Organization. WHO recommendations on care for women with diabetes during pregnancy. Geneva: World Health Organization; 2025.
About This Article
This Diafemme article is intended for educational and informational purposes only. It summarizes key recommendations from the WHO guideline and does not replace individualized medical advice, diagnosis, or treatment from a qualified healthcare professional.
For additional information on women's health and diabetes, visit the Women & Diabetes Knowledge Hub and the Pregnancy & Gestational Diabetes Resource Center.
