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We compared the effects of two treatment strategies (diet alone versus a combination of insulin and diet) on neonatal anthropometric measurements and the outcome of a full-term white infant sample born to mothers with gestational diabetes mellitus (GDM). Study subjects included 217 consecutive nonrandomized women with GDM with term singleton pregnancies. Insulin therapy was administered on the basis of anamnestic and maternal-fetal criteria. One hundred and twenty-one patients (group 1) received a combination of insulin and diet, and 96 (group 2) underwent diet alone. All 1,052 white patients with term singleton pregnancies without GDM, screened at the same time as the study group, formed the control group. The incidence of large-for-gestational-age (LGA) infants was significantly higher in group 2(18.8%) compared with group 1 (9.9%) and the control group (8.3%). Male and female infants born to diabetic mothers of group 2 had significantly greater mean birth weights, ponderal indices, thoracic circumferences, weight/length ratios and significantly smaller mean cranial/thoracic circumference ratios than male and female infants in group 1 and the control group (p < 0.05, Scheffe test). Treatment of GDM mothers with insulin and diet has been shown to be able not only to normalize the incidence of LGA infants but also to influence the anthropometric characteristics of the infants born to these mothers to such an extent that they showed no significant differences compared to infants born to non-diabetic mothers.