Small Bedtime Dose of Terbutaline May Prevent Type 1 Hypoglycemia

Terbutaline, which goes under the trade names Brethine, Bricanyl, and Brethaire, is typically used as a fast-acting bronchodilator in asthma patients. Doctors also use it to delay premature labor. More research is needed to see if it can help type 1s.

Dec 29, 2008

A study of the effectiveness of the drug terbutaline on controlling nighttime hypoglycemia in people with type 1 diabetes indicates that it may be a safe and useful treatment with no ill effects.

Researchers at the Washington University School of Medicine in St. Louis studied 15 type 1 patients (average A1c: 7.1%) to see if terbutaline could prevent hypoglycemic episodes during sleep without causing hyperglycemia the following morning. 

(Terbutaline, which goes under the trade names Brethine, Bricanyl, and Brethaire, is typically used as a fast-acting bronchodilator in asthma patients. Doctors also use it to delay premature labor.)

Some patients were randomly assigned a dose of 2.5 mg of terbutaline each night before going to sleep. A second group received a 5 mg dose. A third group received a placebo. The patients received their respective doses at 10 p.m. on three separate nights.

The mean lowest plasma glucose concentrations at night among the groups were:

  • 2.5 mg: 100 mg/dl
  • 5 mg: 122 mg/dl
  • Placebo: 87 mg/dl

Morning plasma glucose levels were:

  • 2.5 mg: 127 mg/dl
  • 5 mg: 183 mg/dl
  • Placebo: 113 mg/dl

Although the mean figures for the 2.5 mg terbutaline group seem to be closer to the ideal, seven patients in the group reached a nadir nocturnal concentration of 70 mg/dl; six reached 60 mg/dl; and two reached 50 mg/dl in the course of the study. While three patients in the 5 mg group reached a nadir of 70 mg/dl, none in the group reached a lower level. 

The researchers had previously reported on the effectiveness of a 5 mg dose of terbutaline, but were concerned that its morning plasma glucose levels were high. While the study tentatively established the effectiveness of the 2.5 mg dose, researchers have called for a much longer, more extensive trial of the drug among type 1s.

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Categories: A1c Test, Diabetes, Diabetes, Low Blood Sugar, Medications, Medications Research, Type 1 Issues

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Posted by Jerry1423 on 29 December 2008

I may be missing something here, but all terbutaline seemed to do is raise a persons blood sugar. What is the big deal about that???

Posted by cde on 30 December 2008

I agree with Jerry. The placebo group were the only ones with normal (87 mg/dL) or near-normal (113 mg/dL) on arising. Sooooooooo, let's study the PLACEBO, which I imagine was not the usual "sugar pills," in this study. Dr. Stan De Loach México, Distrito Federal

Posted by dejtemper on 2 January 2009

I agree that there is not enough information in this article. How big were these groups? The mean blood glucose level in the placebo group was 87, how low and how high were the individuals in this group? It is interesting, but it looks like there is much more study to be done.

Posted by Anonymous on 2 May 2009

What was the BS before they went to sleep?

Posted by Anonymous on 14 May 2009

All I do is take 6 pcs of saltwater taffy with me to bed and eat them before I go to sleep. I wake up with bs of 110

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