Carbohydrate intolerance in patients receiving oral tocolytics.
This prospective study was designed to evaluate the effects on glucose metabolism of terbutaline used as an oral tocolytic agent. Eighty-six patients were studied when admitted for preterm labor from 24 to 35 weeks' gestation. After intravenous tocolysis, these patients were maintained on 5 mg of terbutaline every 4 or 6 hours. An oral 50 gm, 1-hour glucose challenge test was done 48 hours after terbutaline dosing began. All abnormal glucose challenge test results (greater than or equal to 135 mg/dl) were followed by a standard 100 gm oral glucose tolerance test. Sixty-three percent (54 of 86) of the terbutaline group had an abnormal 1-hour screening result, which was significantly different than the 26.7% (23 of 86) observed in the control group (p less than 0.001). The mean fasting blood sugar and 1-hour postchallenge values were significantly higher in the study than in the control group (p less than 0.0001). Ten of 86 in the treated group (11.6%) and 2 of 86 in the control group (2.3%) with abnormal results met the criteria for gestational diabetes. These numbers achieve statistical significance at p less than 0.05. This study shows a significant effect of oral terbutaline therapy on glucose tolerance during pregnancy. Patients receiving oral terbutaline therapy for suppression of preterm labor should undergo screening for gestational diabetes.
Angel
J L
JL
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
O'Brien
W F
WF
Knuppel
R A
RA
Morales
W J
WJ
Sims
C J
CJ
D000328:Adult; D001623:Betamethasone / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000097:blood / Q000517:prevention & control*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood; D011446:Prospective Studies; D012312:Ritodrine / Q000627:therapeutic use; D013726:Terbutaline / Q000627:therapeutic use
D001786:Blood Glucose; D008278:Magnesium Sulfate; D001623:Betamethasone; D012312:Ritodrine; D013726:Terbutaline