In summary, appropriate assignment of patients to treatment modality utilizing verified blood glucose determination and targeting mean blood glucose level throughout pregnancy to 5.3 mmol/l (similar to normal nondiabetic blood glucose levels) will result in neonatal size comparable to the general population. Today, we have the knowledge and the technology not only to strive for the target but also, more importantly, to achieve the goal of pregnancy outcome in the diabetic comparable to the non-diabetic population. To return to our original research question: Is it glucose or insufficient knowledge of the management approach that maintains macrosomia levels? It is evident that glucose is the prime cause of macrosomia, although other nutrients have a secondary role. Proper management of glucose abnormality will result in a significant decrease in the rate of macrosomia.