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.
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
J L
JL
Angel
W F
WF
O'Brien
R A
RA
Knuppel
W J
WJ
Morales
C J
CJ
Sims
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