NEW YORK (Reuters Health) - A low dose of terbutaline at bedtime appears to prevent a drop in blood glucose, or hypoglycemia, during the night in patients with aggressively treated type 1 diabetes, without causing glucose levels to get too high the following morning, results of a pilot study indicate.

Dr. Philip E. Cryer and colleagues at Washington University School of Medicine in St. Louis previously reported that a 5-milligram dose of the drug prevented nocturnal hypoglycemia, but blood glucose levels were high the next morning.

For their current trial, 15 patients, most with good glucose control, who were an average age of 29 years, were randomly assigned to low-dose or high-dose terbutaline (2.5 or 5.0 mg) or placebo on three separate evenings at 10:00 p.m.

The results are published in the current issue of Diabetes Care.

The average highest nocturnal blood glucose concentrations were 87, 100, or 122 milligrams per decaliter following placebo, 2.5 mg terbutaline or 5 mg terbutaline and placebo treatment. The corresponding blood sugar levels at 7:00 am the next morning were 113, 127, and 183 mg/dL.

Five patients had nighttime blood glucose levels below 50 mg/dL after taking placebo, and two had similar levels after taking low-dose terbutaline. None of those taking the higher dose had glucose levels drop below 60 mg/dL.

Even though the trial was too small to show statistically significant differences between placebo and low-dose terbutaline, the authors note the target dose of terbutaline is more than placebo and less than 5.0 mg.

Cryer's team concludes that larger, controlled studies may show terbutaline to be a safe and effective preventive treatment of nocturnal hypoglycemia in type 1 diabetes.

SOURCE: Diabetes Care, December 2008.

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