NEW YORK (Reuters Health) – A 2.5-mg dose of terbutaline at bedtime appears to prevent hypoglycemia during the night in patients with aggressively treated type 1 diabetes, without causing hyperglycemia 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-mg dose of the beta-2-adrenergic agonist prevented nocturnal hypoglycemia, but blood glucose levels were high the next morning.

For their current randomized, double-blind, crossover trial, 15 patients (mean age 29 years; mean HgA1c 7.1%) were given one of two doses of terbutaline (2.5 or 5.0 mg) or placebo on three separate evenings at 10:00 p.m.

Results published in the December issue of Diabetes Care showed that mean nadir nocturnal plasma glucose concentrations were 87, 11359, and 122 mg/dL following placebo, 2.5 mg terbutaline, and 5 mg terbutaline treatment, respectively. Corresponding levels at 7:00 the next morning were 113, 127, and 183 mg/dL.

Five patients had nadir levels < 50 mg/dL after taking placebo, and two had levels that low after taking low-dose terbutaline. None of those taking the higher dose had nadir levels < 60 mg/dL.

Even though the trial was too small to show statistically significant differences between placebo and low-dose terbutaline, the authors note,