It is overly simplistic to try to identify optimal glycemic thresholds, fetal growth characteristics, and methods of detection in the prevention of fetal overgrowth and its attendant morbidities that can be applied to all pregnancies. We can only hope that, as our understanding of the pathophysiology of diabetes in pregnancy grows, we can "fine-tune" our therapy and surveillance to meet the needs of an individual woman who has diabetes and her fetus.