The impact of nephropathy on the diabetic pregnancy is reviewed. Proteinuria and blood pressure increase, this increase is generally reversible after delivery and the progression of renal insufficiency remains generally unchanged. Arterial hypertension seems to be the only contraindication to pregnancy in a diabetic women with nephropathy. Percentage of premature delivery by cesarean section is high and increases the frequency of hypotrophy and post natal complication especially the respiratory distress of the new born. However, the progress in pediatric intensive care allow the same prognostic what so ever the diabetic women had renal insufficiency or not. The follow up of these pregnancies is assumed by a team of diabetologist, nephrologist and gynecologist. Short acting insulin is mandatory, hypotensive drugs must be used carefully. In spite of the low number of published cases a pregnancy may be successful in a diabetic women after renal transplantation or even after renal and pancreatic transplantation.