Terbutaline and the Prevention of Nocturnal Hypoglycemia in Type 1 Diabetes
- Benjamin A. Cooperberg, MD,
- Suzanne M. Breckenridge, MD,
- Ana Maria Arbelaez, MD and
- Philip E. Cryer, MD
- From the Division of Endocrinology, Metabolism and Lipid Research, Washington University School of Medicine, St. Louis, Missouri
- Corresponding author: Philip E. Cryer, pcryer{at}wustl.edu
Abstract
OBJECTIVE—Bedtime administration of 5.0 mg of the β2-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.
RESEARCH DESIGN AND 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.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 9 September 2008.
P.E.C. has consulted for Merck & Co., Marcadia Biotech, Novo Nordisk, Johnson & Johnson, MannKind, Medtronic MiniMed, Takeda, and TolerRx in recent years.
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- Accepted August 26, 2008.
- Received March 12, 2008.
- DIABETES CARE
