Combined effect of terbutaline and betamethasone on glucose homeostasis in preterm labor.
The short- and long-term effects of simultaneous administration of terbutaline and betamethasone were investigated in 8 gravidas treated for preterm labor. Their plasma concentrations of glucose, insulin, glucagon, C-peptide, lactate and potassium were compared to a control group receiving intravenous magnesium sulfate and betamethasone. The patients on terbutaline therapy had a marked hyperglycemia at 11 h which remained elevated for 48 h. There was a simultaneous rise in plasma insulin and C-peptide, and a fall in plasma glucagon. Lactate levels were markedly elevated. Only 1 of the 8 patients had an abnormal glucose tolerance test at 1 week of therapy. The metabolic changes of control patients were minimal in comparison and there was no lacticacidemia. This suggests that glucocorticoids potentiate the hyperglycemic response of terbutaline.
Adam
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Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Tex. 77030.
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D000328:Adult; D000704:Analysis of Variance; D001623:Betamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D002096:C-Peptide / Q000097:blood; D004338:Drug Combinations; D004357:Drug Synergism; D005260:Female; D005934:Glucagon / Q000097:blood; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D007328:Insulin / Q000097:blood; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011188:Potassium / Q000097:blood; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D013726:Terbutaline / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors; D015145:Tocolysis
D001786:Blood Glucose; D002096:C-Peptide; D004338:Drug Combinations; D007328:Insulin; D007773:Lactates; D019344:Lactic Acid; D005934:Glucagon; D001623:Betamethasone; D013726:Terbutaline; D011188:Potassium