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 of terbutaline prevents nocturnal hypoglycemia without causing morning hyperglycemia.

Research Design and Methods – Randomized, double blind, crossover pilot study – placebo, terbutaline 2.5 mg, terbutaline 5.0 mg – 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 terbutaline 2.5 mg and 122±13 mg/dL following terbutaline 5.0 mg (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.