One hundred eight pregnancies in 98 insulin-dependent diabetic women were managed according to a strict protocol calling for weekly postprandial blood sugar determinations, frequent prenatal contacts, and placental evaluation. Patients were cared for on an ambulatory basis with an average of 1 hospitalization during pregnancy exclusive of delivery. There were no fetal deaths and only 1 neonatal death related to diabetes, for a corrected perinatal mortality of 0.97%. White's classification was not helpful in identifying perinatal risks. The incidence of both perinatal and maternal morbidity was high; however, complications were not serious and the overall outcome was acceptable. In view of the financial and social benefits to patients, it is recommended, that an ambulatory approach to care of the pregnant diabetic patient be used and when feasible it should be the method of choice.