Is it safe? · Pregnancy Smart

Diabetes Preconception Checklist: Planning Pregnancy

Assigned clinical reviewerMichael Yuzefovich· MD, FACOGDraft · pending clinical reviewUpdated September 19, 2026

Evidence summary: consult your healthcare provider

A plain read of what the published evidence shows. The decision belongs with you and your clinician.

The short answer · Diabetes Preconception Checklist: Planning Pregnancy

A diabetes preconception checklist helps you prepare before the earliest weeks of fetal development. Review glucose patterns, medicines, eye and kidney health, blood pressure, nutrition, folic acid, and access to supplies with your care team. Use an individualized plan for conception timing rather than using one A1C result as the entire readiness assessment.

This is a working draft: sourced from published clinical guidance and awaiting sign-off from its assigned clinician. It isn't personal medical advice, so consult your healthcare provider before changing anything in pregnancy.

What does the evidence say about diabetes preconception checklist?

ADA recommends coordinated preconception care involving diabetes, obstetric, nutrition, and education expertise when available. The assessment goes beyond A1C to include complications, severe glucose events, comorbidities, medication compatibility, and barriers to care. 1
Early fetal development begins before some people know they are pregnant. A pre-pregnancy appointment allows time to adjust glucose management and discuss folic acid and other routine preparation. If pregnancy has already occurred, seek care promptly rather than assuming planning is no longer useful. 2
Diabetic eye disease may have no early warning symptoms. A dilated eye examination before pregnancy can identify problems that affect monitoring. Good vision or a recent glasses prescription is not the same as a retinal assessment. 3
NIDDK recommends a complete checkup and review of medicines, nutrition, activity, and diabetes complications. Discuss the practical cost of appointments, insulin, sensors, and other supplies so the plan is achievable. 4
Genetic counseling can help interpret relevant personal or family history and explain testing choices. It is a separate part of reproductive planning, not a substitute for managing diabetes or a guarantee about a future pregnancy. 5

How can you prepare for pregnancy with diabetes?

Before trying, collect records and arrange the diabetes and pregnancy-planning visits.
Before changing contraception, review the agreed health and medication goals with the team.
After a positive test, contact the team promptly and begin the pregnancy-specific monitoring plan.

Questions to discuss with your care team

Decision point	What to clarify
Health baseline	Are glucose patterns, blood pressure, kidneys, and retinal findings reviewed?
Medication transition	Which changes need lead time or another prescriber's input?
Practical readiness	Are supplies, nutrition support, follow-up contacts, and pregnancy goals clear?

Frequently asked questions

Is one A1C result enough to decide I am ready?

No. A1C is useful, but readiness also includes low-glucose risk, daily patterns, medicines, complications, and practical access to care. Ask the team to define an individualized set of goals.

Why plan before the first positive test?

The baby's organs begin forming early, sometimes before pregnancy is recognized. Reviewing glucose and medicines beforehand gives time to make deliberate changes rather than rushing after conception.

Which medicines should I bring to the appointment?

Bring every prescription, over-the-counter product, vitamin, and supplement, with the exact dose. Blood pressure and other non-diabetes medicines also matter. Ask how any change will be coordinated between prescribers.

Do I need an eye check if I can see clearly?

Yes, discuss a dilated examination because early diabetic eye disease can be symptom-free. The eye professional can set the pregnancy and postpartum follow-up schedule according to the findings.

Should I ask about folic acid?

Yes. Review your prenatal vitamin and folic acid plan before conception. The clinician should account for your history and other medicines rather than assuming that more is always better.

What if supplies or specialist visits are unaffordable?

Tell the team. A diabetes educator, social worker, or clinician may help identify resources and a workable monitoring plan. Financial barriers belong in the care discussion, not outside it.

When might genetic counseling be useful?

It may help when there is a relevant family history, a previous affected pregnancy, or questions about inherited conditions and screening. Bring known family results so the consultation can address the actual concern.

What if I am already pregnant?

Arrange an early appointment with the pregnancy and diabetes teams. Continue prescribed care while obtaining a specific review plan. Missing a preconception visit is a reason to start coordinated care now, not to delay further.

References

15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes: 2026
PubMed Central · https://pmc.ncbi.nlm.nih.gov/articles/PMC12690181/
Pregnancy With Type 1 or Type 2 Diabetes
ACOG · https://www.acog.org/womens-health/faqs/pregnancy-with-type-1-or-type-2-diabetes
Diabetic Eye Disease
NIDDK · https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-eye-disease
Pregnancy if You Have Diabetes
NIDDK · https://www.niddk.nih.gov/health-information/diabetes/diabetes-pregnancy
What happens during a genetic consultation?
MedlinePlus · https://medlineplus.gov/genetics/understanding/consult/expectations/

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.