From the FDA Drug Label
Large doses of intravenous terbutaline have been reported to aggravate pre-existing diabetes mellitus and ketoacidosis
- Monitoring glucose is necessary in patients on terbutaline, particularly those with pre-existing diabetes mellitus, as it may aggravate the condition and lead to ketoacidosis 1.
From the Research
Monitor glucose levels closely when using terbutaline, especially in patients with diabetes or at risk for hyperglycemia, as it can cause hyperglycemia as a side effect, stimulating glycogenolysis and gluconeogenesis in the liver and decreasing insulin sensitivity in peripheral tissues 2, 3, 4. Terbutaline, a beta-2 adrenergic agonist, has been shown to increase glucose production and impair glucose tolerance in pregnancy, with studies demonstrating a significant increase in maternal glucose levels after administration of terbutaline 5, 6. Key points to consider when monitoring glucose levels in patients on terbutaline include:
- Checking blood glucose regularly, at least daily, and more frequently if symptoms of high blood sugar occur
- Adjusting insulin or oral hypoglycemic medications as needed based on glucose readings for patients with diabetes
- Monitoring non-diabetic patients, as terbutaline can unmask latent diabetes or impaired glucose tolerance
- Being particularly vigilant during the first few days of treatment and when increasing the dose
- Watching for symptoms of hyperglycemia, including increased thirst, frequent urination, blurred vision, and fatigue If persistent hyperglycemia occurs, consider alternative treatments or consult with an endocrinologist for glucose management strategies while continuing terbutaline if necessary, as the incidence of gestational diabetes and the need for insulin to maintain glycemic control may be increased in patients receiving terbutaline 3, 6.