Diabetes throughout gestation presents challenges that greatly influence maternal and fetal outcomes. Since the degree of maternal hyperglycemia is the most deterministic of these risks, glucose monitoring has become a fundamental tool in the management of diabetes in pregnancy. While most patients with diabetes are in need of improved glucose control, certain circumstances beg for more detailed glucose information than is available by conventional methods alone. In this article, we will review the state of diabetes during pregnancy and the serious outcomes that persist despite the overall improvement in glycemic control today. We will discuss the advantages of incorporating continuous glucose monitoring (CGM), specifically in the treatment of pregnancies complicated by diabetes. In addition to its clinical utility, CGM can advance our understanding and classification of normoglycemia during pregnancy. Demarcation of the normal glucose profile that is present during gestation better defines the therapeutic goals for women with diabetes and ultimately promotes success in pregnancy.