news:1136328327.007516.317500@g44g2000cwa.googlegroups.com...

Yes, they have improved, not gone backwards. My endo was
expecting lower numbers 12 years ago than you are being
advised to achieve today. With further studies into GD,
lower levels held more of a guarantee in preventing birth
defects etc than the numbers you are being advised to aim
for. Obviously you are going to do what you think is right
for you but for me, I would be erring on the side of caution
when it comes to the health and well being of a baby.

That doesn't mean the guidelines are acceptable. Those
guidelines are the same that *were* in use for type 2 yet GD
has to be lower than that.

Um, that review was about IT and there was insufficient data
for reliable conclusions to be made.

http://www.mayoclinic.com/health/gestational-diabetes/DS00316/DSECTION=8

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3
073066&dopt=Abstract

"In a prospective controlled trial, we studied the effect of
tight metabolic control on the outcomes of 102 gestational
diabetes mellitus (GDM) pregnancies compared with outcomes
of 102 matched nondiabetic control pregnancies. Women with
GDM were treated to achieve and maintain a blood glucose
concentration of less than 130 mg/dl at 1 h after breakfast.
Treatment consisted of a diet low in oligosaccharides and
fat and, if necessary, once daily insulin. By the end of
gestation, 88 of the 102 women with GDM received insulin at
a mean dose of 18 U/day. Duration of insulin therapy ranged
from 3 to 32 wk with a median of 11 wk. Perinatal outcome of
GDM pregnancies under this management equaled that of
control pregnancies. The full spectrum of excess morbidity
from GDM was prevented, and normal distribution of birth
weight and normal rates of macrosomia, dystrophy,
hypoglycemia, hypocalcemia, hyperbilirubinemia, fetal
acidosis, and low Apgar scores were achieved. No mortality
was observed. In addition to the two main study groups, we
also studied a third group of 24 women with GDM whose
treatment lasted less than or equal to 5 wk due to late
diagnosis. This suboptimally treated group demonstrated a
significant (P less than .05) increase of macrosomia and
umbilical artery acidosis compared with the well-treated GDM
group. The study reported herein demonstrates that excess
mortality and morbidity typically observed in GDM can be
prevented by early institution of tight metabolic control,
which required insulin in 86% of our patients."

http://tinyurl.com/7pmnm :

"The classification, diagnosis, treatment and follow-up of
patients with GDM were performed according to the specific
recommendations proposed by American Diabetes Association
(1) and the American College of Obstetrics and Gynecology
(2). During the study period 1980-1989, patients with
fasting glucose levels of >5.8mmol/L or postprandial levels
of >7.8 mmol/L were given insulin treatment. Between 1990
and 1992, patients were also instructed to aim maintain a
plasma glucose level of 5.8 mmol/L. As of 1993 insulin was
started at fasting levels of =5.3 mmol/L and/or 2-h
postprandial levels of 6.6 mmol/l, and the glycemic goal was
set at =5.3 mmol/L."

5.3=95
6.6=118

Note the change of bg goal changed between 1990 and 1992 and
the change for insulin introduction in 1993. I became
pregnant with my 4th GD in 1994 and the above guidelines
were what my endo used. So you can see that guidelines
changed as far back as 1993.

"We hypothesized that in the management of pregnancies with
GDM combining early detection and strict metabolic control
with early induction of labor near term- to avoid excessive
fetal growth in utero, could lead to more favorable
perinatal outcome. To test this assumption, we studied
pregnancy outcome in GDM patients compared with the non-GDM
normal pregnant population over a period of 18 years in
which none, some, or all of these criteria were applied. The
results indicate a gradual and constant decline in several
important feto-maternal complications (for comprehensive
data, see reference 3).During the last follow up period
(1993-1998), the target normoglycemic level was lowered to
=5.3 mmol/L, strict metabolic control was implemented, and
labor was induced at a lower mean gestational age according
to the EFW. It is only after applying all three aspects of
the management policy together that we succeeded to decrease
the complications occurring in GDM patients to rates that
compared favorably with those observed in the general
non-GDM population."