The association between diabetes during pregnancy and the risk of adverse maternal and fetal outcome is well established. Maternal complications include spontaneous abortions, preterm deliveries, preeclampsia, nephropathy, cesarean section, and among others birth trauma. The main fetal and neonatal complications are congenital anomalies, deviant fetal growth, birth-related trauma, metabolic abnormalities, and stillbirth. Moreover, evolving evidence indicate that diabetes, among other components of the metabolic syndrome, is a significant risk factor for childhood and adult obesity and cardiovascular disease, due to in utero programming mechanisms including altered organ development, cellular signaling responses, and epigenetic modifications of gene expression. 1 4