title: Terbutaline and the prevention of nocturnal hypoglycemia in type 1 diabetes.
abstract: 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.
authors.affiliation: Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Cooperberg
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Breckenridge
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Arbelaez
authors.forename: Philip E
authors.initials: PE
authors.lastname: Cryer
mesh_terms: 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*
chemical_list: D000318:Adrenergic beta-Agonists; D013726:Terbutaline
references.citation: PLoS Med. 2007 Feb;4(2):e69
references.pmid: 17326710
references.citation: J Clin Endocrinol Metab. 2006 Jun;91(6):2087-92
references.pmid: 16492699
references.citation: N Engl J Med. 2004 May 27;350(22):2272-9
references.pmid: 15163777
references.citation: Diabet Med. 2007 May;24(5):527-32
references.pmid: 17381503
references.citation: Diabetes Care. 2005 May;28(5):1245-9
references.pmid: 15855602
references.citation: N Engl J Med. 1998 Jun 4;338(23):1657-62
references.pmid: 9614256
references.citation: Diabetes. 2003 May;52(5):1195-203
references.pmid: 12716752
references.citation: Diabetes. 1997 Feb;46(2):271-86
references.pmid: 9000705