10. Stop ACE inhibitors or ARBs. If you are taking a medication in either of these two classes of medications because of renal disease (protein in your urine) or hypertension (high blood pressure), then this drug needs to be stopped prior to conception. However, the protein in your urine may return during the pregnancy. If you do have kidney disease then you should consult with your endocrinologist and a high-risk pregnancy specialist. There are additional increased risks to a pregnancy. The decision for a pregnancy in this circumstance should be made very carefully.

11. Talk to a dietitian if it's been a while. There are lots of new ideas, such as carb counting, that you might not know about.
 
12. Get your eyes examined. If the blood sugar levels are aggressively lowered to obtain tight control, there's a chance of developing worsening retinopathy. Therefore, the eyes should be checked by a qualified opthalmologist, preferably before conception, or during the first trimester of pregnancy, and perhaps again during the third trimester of the pregnancy.
 
13. Get a 24-hour urine sample to assess how your kidneys are doing. The two lab tests that should be checked are called "creatinine clearance" and "24-hour urine protein".
 
14. Start checking urine ketones every morning. It'll be recommended during pregnancy, and you might as well start now.

15. Carry quick-acting carbohydrate to treat possible hypoglycemia.

16. Be sure your spouse and anyone else nearby knows how to give you a glucagon shot if you're knocked out by low blood sugar. Keep a Glucagon Emergency Kit handy (and be sure your family and friends know where it is!).

17. Stop smoking. There are several ways of doing this. Consult with your physician about how to approach it.

18. Always wear identification that you have diabetes. With the very tight control that is recommended, you might have a severe insulin reaction that would need help from someone else.

19. Plan to stay very active both before and during pregnancy, until your obstetrician tells you to slow down. Diabetes is not a reason to slow down; actually the reverse seems true: the more you exercise, the easier it should be to keep your blood sugar levels down.
     
20. Be sure that you are comfortable with the obstetrician who will be caring for you. If you don't yet have an "OB," get one, and be sure you discuss each other's expectations about diabetes care during pregnancy, before you become pregnant.

That's quite a list, but with good planning and lots of work, the chances for a successful pregnancy for the woman with diabetes is excellent.

Want to hear from someone who's been there? Read expert Kelsey Bonilla's posts and find out how she managed her pregnancy with diabetes.