WHO Norms on Diabetes During Pregnancy Out

  • November 16, 2025
  • Governance

Morning Standard

WHO Norms on Diabetes During Pregnancy Out

1. Introduction and Context

This article reports on the World Health Organization’s first-ever global guidelines for managing diabetes during pregnancy — a major public health milestone, given that one in six pregnancies worldwide is affected by diabetes.

The piece underscores:

  • the danger diabetes poses to mothers and babies,
  • the global inequality in access to maternal care, and
  • the urgent need for evidence-based, structured interventions.

It frames diabetes in pregnancy as both a medical emergency and a systemic public health challenge, especially for low- and middle-income countries (LMICs) like India.

2. Key Arguments Presented

a. Diabetes in Pregnancy Is a Global Health Emergency

  • Affects 21 million pregnancies annually.
  • Increases risk of pre-eclampsia, stillbirth, and birth injuries.
  • Mothers and babies face long-term risk of type 2 diabetes.

The scale indicates a global maternal health crisis.

b. WHO Issues 27 New Clinical and Policy Recommendations

The guidelines focus on:

  • Early and universal screening
  • Regular antenatal monitoring
  • Diet + physical activity protocols
  • Clear glucose targets
  • Medicines guidelines for Type 1, Type 2, and gestational diabetes
  • Multidisciplinary care for women with pre-existing diabetes

These recommendations apply across low-resource, middle-income, and high-income contexts.

c. Special Focus on LMICs

Because LMICs face:

  • low antenatal care coverage
  • costly insulin and testing kits
  • workforce shortages
  • weak integrated NCD–maternal care systems

WHO urges strengthening primary care and affordable medicines access.

d. Life-Course Approach to Diabetes Management

Aligned with World Diabetes Day 2025 theme — "Diabetes Across Life Stages" — the article stresses:

  • nutrition and preventive care from childhood
  • access to screening at reproductive age
  • consistent lifelong care
  • reducing stigma for women with gestational diabetes

e. Rising Diabetes Burden in India

ICMR findings highlight:

  • 101 million diabetics in India
  • Explosive rise, especially among poorer households
  • High gestational diabetes rates (10–14%)

This makes India a priority country for implementing WHO’s recommendations.

3. Author’s Stance

The stance is highly supportive of WHO’s guidelines, seeing them as:

  • timely
  • evidence-based
  • essential for global maternal health

Tone: advocacy-driven, urgent, pro-public health.
The author does not question feasibility or operational complexity — the goal is awareness.

4. Biases and Limitations

Bias

  • Strong pro-WHO, pro-guideline narrative.
  • Assumes countries can implement all 27 recommendations despite resource constraints.
  • Limited acknowledgment of systemic challenges (shortage of endocrinologists, diagnostic labs, ASHA workload, unaffordable insulin).

Limitations

  • No India-specific barriers such as rural antenatal care shortages, cultural stigma, or late pregnancy registration.
  • No discussion on financial burden on families.
  • Omits scientific details of diagnostic tests (e.g., OGTT thresholds).
  • Does not assess feasibility in remote tribal or conflict-prone regions.

5. Pros and Cons of the Argument

Pros

  • Global perspective, high relevance to maternal health.
  • Clear description of WHO recommendations.
  • Data-rich and useful for public health students and policymakers.
  • Raises awareness on a critical but under-discussed issue.

Cons

  • Lacks depth on implementation challenges.
  • No critical evaluation of WHO evidence and methodologies.
  • Oversimplifies diabetes management in low-resource health systems.
  • Economic implications and financing strategies are absent.

6. Policy Implications

For India and other LMICs

i. Strengthen Maternal Health Infrastructure

  • Increase antenatal care access, especially at PHC/CHC levels.
  • Improve early screening capacity (OGTT availability).

ii. Improve Access and Affordability of Medicines

  • Reduce price of insulin and glucometers.
  • Expand Jan Aushadhi for diabetes supplies.

iii. Integrate Diabetes Screening with RMNCH Programs

  • Embed guidelines into:
    ✓ National Health Mission (NHM)
    ✓ POSHAN Abhiyaan
    ✓ PM-JAY maternity packages

iv. Train ASHAs/ANMs for Early Detection

  • Gestational diabetes counselling
  • Dietary guidance
  • Follow-up adherence tracking

v. Use Digital Health Tools

  • Telemedicine for high-risk pregnancy management
  • Digital reminders for glucose testing
  • AI-based risk prediction

vi. Nutrition Interventions

  • Strengthen anganwadi supplementation
  • Address anaemia + gestational diabetes together

7. Real-World Impact

If effectively implemented:

  • Lower maternal and neonatal mortality
  • Fewer complications during pregnancy
  • Reduced future diabetes burden
  • Strengthened primary care systems

If not implemented:

  • Worsening inequalities for poor and rural women
  • Higher hospitalization and ICU costs
  • Increased lifetime diabetes risk for mothers and children
  • Overburdened tertiary hospitals

This makes implementation a critical equity issue.

8. Alignment with UPSC GS Papers

GS Paper II – Governance

  • WHO’s role in global health
  • Maternal and child health policies
  • International guidelines and national programs
  • Health system strengthening

GS Paper III – Public Health

  • NCD burden
  • Preventive healthcare
  • Health financing and accessibility
  • Nutrition and maternal health

GS Paper IV – Ethics

  • Equity in healthcare
  • State’s duty to protect vulnerable populations (pregnant women)
  • Justice in access to medicines

Essay Paper

Themes:

  • Public health governance
  • Maternal care reforms
  • NCD crisis in developing nations
  • Preventive healthcare as national strategy

9. Conclusion and Future Perspectives

This editorial captures a landmark global development — WHO’s first guidelines for diabetes in pregnancy.
It effectively highlights the urgency but does not deeply engage with feasibility challenges.

For real change, countries must:

  • Build stronger primary care systems
  • Make diagnostics and insulin affordable
  • Train frontline health workers
  • Integrate NCD and maternal health programs
  • Promote nutrition and early screening

A life-course, equity-based approach is essential to reduce India’s rising diabetes burden and protect maternal health.