The ADIPS Diabetes Contraception and Pre-pregnancy Management Task and Finish Group membership comprises experts in the field of endocrinology, obstetrics and gynaecology, contraception, preconception care, diabetes program management, consumer organisation, and research. The group was established to investigate and suggests ways to improve the monitoring and visibility of the issue of preparation for pregnancy among women with pre-existing diabetes. Currently in Australia, limited pregnancy preparation including suboptimal blood glucose management at the beginning of pregnancy results in rates of congenital malformations that are three to four times higher than the general population. The key recommendations from the group, which seeks to reduce unintended and underprepared pregnancies through improving preconception and antenatal care amongst women with Diabetes Mellitus, also includes improved data collection, education of health care professionals and consumers, health system reform and health policy changes. Data collection on the uptake and quality of preconception care for women with diabetes mellitus as well as on the establishment of a national clinical quality register on antenatal diabetes management and pregnancy outcomes will be crucial for the monitoring of any improvements if the recommendations are implemented. Education of health care practitioners who work with women with pre-existing diabetes around the importance of frequent and informed discussions on reproductive life planning has the potential to improve women’s access to reliable contraception if they are not planning a pregnancy and to improve their access to preconception care if they are.