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There is a growing volume of evidence that supports the importance of treatment of Gestational Diabetes Mellitus as risk reducers of perinatal complications (such as respiratory distress, hypoglycemia, hyperbilirubinemia, etc). Although the focus is on fetal macrosomia and future appearance of chronic noncommunicable diseases, we know that the effect can be modified by healthy family habits and optimal metabolic control. In pregnant women with pregestational diabetes mellitus, preconceptional careis essential to avoid the risks of congenital malformations, hypoglycemia in the first trimester and illness progression.By insisting on the importance of adequate metabolic control prior to gestation, with metabolic optimization and the use of appropriate drugs, it is possible to achieve adecuate fetal growth and minimize the occurrence of adverse events.