AimsThis study assesses the impact of pregnancy and pre-pregnancy care on longer-term treatment goals in women with diabetes.MethodsThis retrospective study included women with Type1 (n=247) and Type2 diabetes (n=137) who were evaluated before, during and after pregnancy.ResultsAmong women with Type1 diabetes, average HbA(1c) at 12months post-partum was similar to the preconception level [63 vs. 64mmol/mol (7.9% vs. 8.0%), P=0.60]. This was also the case for women with Type2 diabetes [52 vs. 52mmol/mol (6.9% vs. 6.9%), P=0.79]. At 12months post-partum, there was no improvement in other measures of diabetes control and one in five women are lost to follow-up from clinical care. In total, 44.9% of women with Type1 diabetes and 27.7% of those with Type2 diabetes attended pre-pregnancy care. Attendees maintained superior glycaemic control throughout the study and were more likely to be receiving specialist care post-partum.ConclusionsThese findings identify a need to change our approach to the reproductive care of women with diabetes. In particular, efforts should be made to ensure all women have access to and attend pre-pregnancy care, and barriers to engagement with post-partum care should be addressed.