Gestational diabetes historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]

Diabetes mellitus is an ancient term first found in the Egyptian Eberes papyrus around 1500 BC. Hyperglycemia in pregnancy was first described by Bennewitz, a German physician in 1824. In 1950, the term ‘GDM’ was accepted.

• Diabetes mellitus was first described in the Egyptian Eberes papyrus around 1500 BC.^[1]
• Hyperglycemia in pregnancy was first described by Bennewitz, a German physician in 1824.^[1]
• Before the discovery of insulin in 1922, infertility was well recognized in women with diabetes.
• In 1856, the presence of physiological glycosuria in pregnancy and lactation was first described.
• Brocard in 1898, demonstrated for the first time that pregnant women were less tolerant to sugar compared to non-pregnant women; he found the presence of glycosuria 2 hours after the ingestion of 50 g of glucose in 50% of pregnant women compared to 11% found in non-pregnant women.
• Skipper in 1933, published a vast review of the literature on the use of insulin in pregnancy and found a dramatic improvement in maternal mortality, and a modest impact on fetal and neonatal outcomes and survival.
• In the 1950s, many risk factors for the development of abnormalities in carbohydrate metabolism during pregnancy were defined and the term gestational diabetes mellitus (GDM) became accepted.^[2][3][4]
• John B. O’Sullivan, Wilkerson and Remein in 1957, proposed offering a 3-hour oral glucose tolerance test (OGTT) for patients presenting with risk factors for diabetes such as a family history of diabetes, gestational glycosuria and overdeveloped infants at birth.^[3]
• For women without known risk factors, they proposed determining a 1-hour blood glucose value after the ingestion of a 50 g glucose load. A value of 130 mg or more was considered abnormal and a 3-hour OGTT should be performed afterwards.^[3]

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