Gestational diabetes and refusal of treatment

 Gestational diabetes and refusal of treatment

A client has elevated (as per new guidelines) fasting blood glucose levels in the range of 5.5 to 6 mm/l. Her post prandial levels are also consistently going over 6.7 mm/l. and sometimes up to 8mm/l. The baby scan recently showed that the baby is above the normal growth range for the dates. The client has been reluctant to engage with the services and in a four week period has omitted sending her levels in and not returning emails or phone calls. You finally manage to speak to her husband who reads the first week’s levels out to you over the phone and they are elevated. You alert the obstetrician and midwife to the situation. You manage to catch her at her next obstetric appointment and speak with the client about the need for insulin. The client flatly refuses to go onto insulin. After reinforcing the consequences of a big baby she states that ‘she wants a big baby’ and that she ran her doctor in India and he said she didn’t have to do anything. She accuses us of ‘stressing her out’ and she does not wish to see us again. The client states that she is ‘hardly eating carbohydrates anyway’.

refer to;-
Respect for autonomy
Beneficence
Non-maleficence
Confidentiality
Duty of care
Mandatory reporting
Incident reporting

1000 words
APA style
UK English

 

 

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