The risk to a woman of having diabetes during her reproductive years varies worldwide and compares with the regional risks for the condition in general – on average between 5% and 8%. In all pregnant women, the risk for gestational diabetes should be assessed and screened early if a number of risk factors are present. Indeed, any form of diabetes during gestation, whether it develops during pregnancy or is present before conception, requires excellent multi-facetted management before and during pregnancy, and around the time of delivery. Sara Meltzer reports on strategies to minimize the health risks and potential diabetes-related complications for the mother and her child.