to refuse this test?

[toddlerama]

I'm 28+ wks pregnant and measuring 33. By my own dates, I'm actually 30 weeks, but whatever.

I have been asked to make an appointment for a glucose tolerance test which I have declined to do. My midwife isn't worried, but my consultant just shuts me down and states "make the appointment". Wont discuss it at all.

My reasons for declining it are these:

They want me to spend 2.5 hours at the hospital for it. I can't go home and I can't bring my children (aged 3 and 4). No negotiations on this, and I have no childcare available.

I will be having my 3rd elective section. My understanding is that the biggest risk relating to gestational diabetes is "a big baby". So what? I don't have to push it out. My last 2 were 9 and 10 pounds respectively. I know I'm having a big baby. This isn't news.

Because my last 2 measured large, I had the GTT with both of them. Negative both times. With DD2 I actually had to have it twice because they couldn't believe I was having a child that size for any other reasons.

The fasting nature of the blood test means I will be vomiting into the cardboard bowler hat until I can eat and drink again (from waking up until after midday if previous waits are anything to go by).

I can only have blood drawn from the back of my hand. The vacuum-tube things don't work as they pull too fast and I have to have it done with a manual syringe and squirted into the tubes afterwards. They can rarely get enough for what they need. This is due to really low blood pressure/crap veins/genetics - my mum and grandfather have the same issue. My sister has had to have it drawn from her ankle, so could be worse....

Because it's so hard to get into the vein, at my last section we nearly reached an impasse as my hand veins were so scarred on both sides they couldn't fit a canula. I don't know what would have happened if they hadn't called in another anaesthetist. I had one hand split right open and the other no-one wanted to try in case it happened again. They just stood there looking at each other. Another guy poked his head round the door, yelled at them, made the original anaesthetist stand in the corner (!!!) whilst he did it. Thank God he turned up, but honestly... I don't want to have any blood work I don't absolutely need because of this. I don't want a repeat performance. I want my veins in tip top shape on the day.

I have to have the 28 wk bloods done asap anyway, and I think 3 blood tests in this space of time is going to cause the same problems.

I invariably faint when they take blood. Don't know why. Just fade out as it goes on. I don't want to. It makes me feel sick and then I have to drive home all woozy.

I have no symptoms of diabetes at all. Except the big baby, which I always have!

Sorry for the epic post but I'm trying to articulate all the reasons to give a full picture. I don't just 'think I know best' (well, maybe a little bit ) but with these factors, would you bother?

Yep your neck. Sorry...

Good luck working through it all and deciding what is best for you

Could you ask to bypass the GTT, monitor your sugars daily yourself and then be treated as if you had GD eg regular scans and that other test that I can't remember the name of when the put a CTG on and measure the baby's movement?
Since you are having a larger baby anyway the regular monitering may already be part of your careplan.

Fwiw, I completely think YANBU, especially given the lack of response from your consultant to your points. But if something were to go wrong with the baby, would you always wonder whether it was because you did have GD and, if they had known, could have done something which might have made a difference? Not very constructive, I know, but better to think through the "what if"s before rather than after.

Right speak to the consultant and ask what they would do differently if you did have GD. If it's a diet change then do that anyway. Ask whether they think they would need to induce you before 38 weeks anyway if you had GD. I suspect the answer is that that is unlikely. In which case you may not need to have the GTT as it won't actually change very much. If they would provide additional scans ask if you could have those anyway to monitor baby's growth if you remain large for dates. They may be happy with this. It does sound as though physically you would struggle to have the GTT.

yanbu, I bailed on mine too. The reason was I was an older mother. Its a huge hassle

I had negative tests in my first 2 pregnancies too. Third pregnancy I thought what a waste of time but it was positive! In fact I was so diabetic I had to inject insulin 3 times a day.

Personally I'd have the tests as its not worth the risk to the baby if you do have GD.
Agree HCP should have given you more information to make an informed decision. This is what they do and are experts in and have your and your babies best interests central.
Speak to the unit about how they can solve the IV access issue, allow them 2 attempts and if unsuccessful ask for someone more senior.
I totally disagree with the "take the DC anyway" comments. A hospital is not the best place for young DC, infections and medical procedures, they may increase your stress levels which will effect result and if god forbid you were unwell during tests, who would comfort and care for them?
Good luck, hope you make the right decision

I think you should have the test. I also know someone whose baby was stillborn because GD went undiagnosed.

It really isn't worth the risk to your baby to just assume the result will be the same this time as before.

I hope that things are alright for you, but speaking as someone who has had an unexplained stillbirth I would urge anyone to take whatever tests necessary if their is any doubt that their baby may be affected. We were told there was no reason for our loss, but still we wonder and feel guilty, thinking we could have done something differently. Having the test can rule out a serious condition or get help if you need it, and that can only be a good thing, can't it?

This makes really interesting reading. Round here you don't get offered a gtt over 26 weeks. (or so I was told at 28 weeks when I scored my second positive glucose in urine test)...

Well, it appears to be moot anyway. Went for routine 28 wk blood test (at nearly 30wks) and they laughed in my face when I said I had been asked to book in for a GTT. After 2 failed attempts, the third phlebotomist got a dribble from a knuckle in my left hand. There's no way they'd get enough again in 3 hours so it's not going to happen. Thanks for the advice and support everyone, it really helped a stressful decision making process to thrash it out on here even if it's out of my hands in the end anyway.

Not sure if its been said but if you do have GD then your baby could go into a coma when born because it will be making high levels of insulin to cope with your high blood sugars, when its born it no longer has the high sugars but still has the high insulin levels.
I had uncontrolled GD and was warned to call an ambulance if I went into labour as delivering alone was too risky.
Have the test :) I'm sure there must be a way of doing it as its so important.

I do know that now crazychicken but right now, I can't produce any more blood so I can't really do anything about it.

Yabu, who will have the children when you go in for section.???? They don't do these tests for something to do. You may not know you have GD and putting baby at risk.Crazy

I refused this test when I was pregnant with ds2 and ds3. I am overweight, and it's like they looked at me and decided I must have gestational diabetes. My first baby was 7lb2.5oz, and I never had glucose in my urine at any of my antenatal visits in any of the three pregnancies, but they still wanted to do the test. I refused.

During my pg with dd2 I was overweight and like SDTG felt like I was being treated differently simply because of the weight. I hadn't had any +ve glucose urine tests. I had passed a GTT when pg with dd1 (at that time it wasn't done routinely because of high BMI and I had one because of two +ve urine tests as I stupidly drank sugary drinks before my mw appts). They were just making me do this test because the policy had changed in my area and all high BMI patients were offered one. I felt discriminated against for being fat! It was a pointless waste of NHS resources I thought, but kept my grumblings to myself and went anyway.

I am so glad I did. GD diagnosis. I couldn't believe it.

Long story short, diet management (despite sticking to it religiously) didn't work and I ended up on insulin.

DD2 was born just hours before I was due to be induced at 38w (clever girl ) but became very ill with a blood condition that is linked with diabetes in the mother.

I dread to think what would have happened if I hadn't had the diagnosis and all the HCPs been prepared for complications.

I know it's now moot for you OP, but wanted to tell my story in case others stumble across this thread. It isn't a big deal (usually) to have the test, it's two hours of your life but it may well just save your baby's.