The objective of the present study was to assess (i) the effects of immigration on the outcome of 200 consecutive singleton pregnancies in women with overt diabetes as well as (ii) gender-specific differences in cardiovascular risk factor profile and the achievement of therapeutic targets in type 2 diabetic subjects with migration background (n = 50). In pregnant subjects, baseline characteristics at admission, pregnancy outcome and the rate of obstetrical complications were similar in immigrant and non-immigrant women. Type 2 diabetes and also preconceptionally undiagnosed diabetes were significantly more frequent in women with migration background. Following delivery, immigrants presented with a worse metabolic profile, including higher triglyceride and nonHDL levels, than the indigenous population. Furthermore, within diabetic subjects with a migration background, non-pregnant women feature a more adverse cardiovascular risk factor profile than men. However, no gender-specific differences in the total adherence to clinical recommendations according to clinical recommendations have been found.