Terbutaline and the prevention of nocturnal hypoglycemia in type 1 diabetes.
OBJECTIVE
Bedtime administration of 5.0 mg of the beta(2)-adrenergic agonist terbutaline prevents nocturnal hypoglycemia but causes morning hyperglycemia in type 1 diabetes. We tested the hypothesis that 2.5 mg terbutaline prevents nocturnal hypoglycemia without causing morning hyperglycemia.


METHODS
This was a randomized double-blind crossover pilot study (placebo, 2.5 mg terbutaline, and 5.0 mg terbutaline) in 15 patients with type 1 diabetes.


RESULTS
Mean +/- SE nadir nocturnal plasma glucose concentrations were 87 +/- 14 mg/dl following placebo, 100 +/- 14 mg/dl following 2.5 mg terbutaline, and 122 +/- 13 mg/dl following 5.0 mg terbutaline (P < 0.05 vs. placebo). Nadir levels were <50 mg/dl in 5, 2, and 0 patients (P < 0.05 vs. placebo), respectively. Morning levels were 113 +/- 18, 127 +/- 17, and 183 +/- 19 mg/dl (P < 0.02 vs. placebo), respectively.


CONCLUSIONS
Terbutaline may be shown to be effective and safe in the prevention of nocturnal hypoglycemia in type 1 diabetes in a suitably powered randomized controlled trial.
Cooperberg
Benjamin A
BA
Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
Breckenridge
Suzanne M
SM
Arbelaez
Ana Maria
AM
Cryer
Philip E
PE
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control*; D008297:Male; D013726:Terbutaline / Q000627:therapeutic use*
D000318:Adrenergic beta-Agonists; D013726:Terbutaline
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