Summary: Disorders of carbohydrate metabolism in pregnancy are currently the most frequent obstetric pathology. Proper diagnosis and treatment reduces the risk for both mother and offspring. All pregnant women should be screened for diabetes, and those with risk factors present before pregnancy are eligible for a diagnostic test with 75 g glucose once pregnant. Women with pregestational diabetes should be subject to re-education regarding diet, glucose monitoring and insulin therapy as well as an assessment for long-term complications and methods of treatment of accompanying disorders. The basis for the treatment of carbohydrate metabolism disorders during pregnancy is a diet with an appropriate nutritional composition and calorie content. Nutritional treatment is effective in most women with diabetes diagnosed for the first time in pregnancy. In Poland, insulin is the only antidiabetic medicine approved for treatment during pregnancy, however metformin can be continued in special situations (e.g. polycystic ovarian syndrome). Multiple daily injections are most often used in treating diabetes in pregnancy, and in patients with type 1 diabetes it is reasonable to consider the use of an insulin pump. Regardless of the type of carbohydrate metabolism disorder and the treatment method, achieving optimal metabolic control of diabetes (glycated hemoglobin HbA1c < 6.5%) is crucial, as it effectively limits the number of complications in women and newborns.