Metabolic and circulatory effects of intravenous and oral salbutamol in late pregnancy in diabetic and non-diabetic women

Abstract

The present study investigated the cardiovascular and metabolic "side-effects" of the beta 2-adrenoceptor stimulating drug salbutamol in the third trimester of pregnancy in diabetic and non-diabetic women. Salbutamol was administered either orally or as an intravenous infusion. Blood samples were collected for analyses of plasma cyclic AMP, insulin, C-peptide, and carbohydrate and lipid metabolites. Fetal heart rate, maternal heart rate, and blood pressure were registered simultaneously. After both intravenous and oral salbutamol, there was a statistically significant decrease in diastolic blood pressure, increase in maternal heart rate, plasma levels of cyclic AMP, insulin, and carbohydrate and lipid metabolites showing stimulation of glycogenolysis, lipolysis, and insulin secretion. The increase in fetal heart rate was slight. In diabetic women, the glycogenolytic and lipolytic effects of salbutamol were significantly more pronounced than in non-diabetics. The acute maternal circulatory and metabolic effects after salbutamol are probably too slight to have any clinical significance in healthy women. However, in diabetics, due to their impaired insulin function, a serious metabolic deterioration after salbutamol might occur.