Gestational diabetes mellitus is a common disorder of pregnancy affecting 3-5% of pregnant women. Although significant controversy exists regarding its diagnosis and treatment, macrosomia has been consistently associated with maternal hyperglycemia. Numerous studies have addressed different approaches to monitoring blood glucose levels, but data on the ideal timing for postprandial determinations are scarce. This article reviews current recommendations and recent findings on the implications of 1- versus 2-h blood glucose determinations in pregnant women with gestational diabetes mellitus. Preliminary studies have shown a statistically significant reduction in macrosomia and decreased need for emergency Cesarean section among women monitored 1 h after meals. Until larger studies confirm these benefits, compliance is of the utmost importance for successful treatment. Therefore, patient preferences should be considered in planning a monitoring strategy.