Use of β-2 adrenergic receptor (AR) agonists have been linked to a reduction in nocturnal hypoglycemia, but the efficacy of long-acting inhaled β-2 agonists for the treatment or prevention of hypoglycemia is unknown. Research in Diabetes Care describes a study in which seven patients with type 1 diabetes and seven healthy control subjects received inhaled formoterol 48mcg or placebo during a hyperinsulinemic-hypoglycemic clamp study to determine its efficacy in antagonizing the effect of insulin. In a second study, five subjects with type 1 diabetes received inhaled formoterol to evaluate its efficacy as a preventive treatment for insulin-induced hypoglycemia.

In the first study, inhaled formoterol reduced the glucose infusion rate required to maintain plasma glucose at target levels by 45–50% vs. placebo (P<0.05). No significant effect was seen on glucagon, epinephrine, cortisol, or growth hormone release. In participants with type 1 diabetes, glucose levels dropped to 58 ± 5mg/dL one hour after increasing basal insulin delivery twofold, whereas hypoglycemia was prevented by inhaled formoterol (P<0.001).

Inhalation of formoterol could be helpful in the prevention or treatment of acute hypoglycemia in patients with type 1 diabetes, but additional studies are needed to assess its safety and efficacy. Currently formoterol is used in the treatment and maintenance of asthma and chronic obstructive pulmonary disease (COPD).

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