What is the most important advice a nurse should give to a female client with insulin-dependent diabetes who wishes to get pregnant?

Maintaining blood sugar levels within normal limits during pregnancy is crucial for a woman with insulin-dependent diabetes who wishes to conceive. Proper glycemic control is vital not only for the health of the mother but also for the developing fetus. High blood sugar levels can lead to a variety of complications, such as fetal macrosomia, congenital anomalies, and an increased risk of miscarriage. Achieving and maintaining stable blood glucose levels can reduce these risks significantly and promote a healthier pregnancy outcome.

The other options may suggest various strategies related to insulin management, but they do not emphasize the primary importance of overall blood sugar control. While it is essential to adjust insulin dosages as needed, making sure that blood sugar remains well-regulated takes precedence. It is also important to note that with appropriate management, many women with diabetes can have healthy pregnancies, countering the notion presented in one of the incorrect options. Thus, keeping blood sugar levels within normal ranges is fundamentally the most critical piece of advice for the client.