From the FDA Drug Label
Large doses of intravenous albuterol have been reported to aggravate preexisting diabetes mellitus and ketoacidosis
- Diabetics can use bronchodilators, but with caution.
- The reason for caution is that large doses of bronchodilators (like albuterol) may aggravate preexisting diabetes mellitus and ketoacidosis 1.
From the Research
Diabetics can generally use bronchodilators safely, but they should be aware of the potential effects on blood glucose levels, particularly with beta-2 agonists like albuterol, which may temporarily raise blood glucose levels by stimulating glycogenolysis in the liver 2.
Key Considerations
- Bronchodilators like albuterol, formoterol, salmeterol, and tiotropium are commonly prescribed for asthma and COPD regardless of diabetic status.
- Short-acting bronchodilators typically cause minimal blood sugar fluctuations, while long-acting or high-dose bronchodilators may have more noticeable effects.
- Inhaled anticholinergic bronchodilators like ipratropium and tiotropium generally have less impact on blood glucose levels and may be preferable options for some diabetic patients.
Recommendations
- Diabetic patients using bronchodilators should monitor their blood glucose more frequently when starting these medications and report significant changes to their healthcare provider.
- The benefits of treating respiratory conditions with bronchodilators usually outweigh the potential for minor blood glucose fluctuations.
Evidence Summary
The most recent and highest quality study on this topic is from 2022, which discusses the rationale and clinical use of bronchodilators in adults with bronchiectasis 3. However, the study that directly addresses the question of bronchodilator use in diabetics is from 2020, which provides information on the efficacy and safety of short-acting inhaled β2-agonists in the management of obstructive diseases in children and adults 2. Other studies, such as those from 2003 and 2008, provide additional information on the use of bronchodilators in patients with COPD and the potential adverse effects of these medications in older people 4, 5.