1990 Overview of GDM: Accomplishments of the Last Decade—Challenges for the Future

The First International Workshop-Conference on Gestational Diabetes Mellitus (GDM) was held in the fall of 1979 on the campus of Northwestern University Medical School. The purpose of that event was to examine the impact of mild disturbances of maternal metabolism on fetal development. The conference sought to “establish how such disturbances can be detected most effectively; whether all pregnant subjects should be examined for them; and whether positive identification justifies therapeutic attempts at rectification” (1). In his opening remarks, Norbert Freinkel (1) anticipated some of the issues that are of greatest importance more than a decade later. In particular, he stressed the public-health implications that would follow national and worldwide detection of GDM. Five years later, the Second International Workshop-Conference on GDM provided an opportunity for reappraisal of many of the same issues. The proceedings of each conference concluded with summary statements drafted by the participants (2,3). Both included the recommendation that all women (not known to have diabetes) should be screened for glucose intolerance during pregnancy by measurement of plasma glucose after an oral glucose challenge. The recommendations from the second conference formed the basis of a position statement on GDM that was adopted by the board of directors of the American Diabetes Association (4).