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A preliminary study to determine the effects of nebulised salbutamol on blood glucose levels during an acute asthma exacerbation

Introduction: The commonality of shared comorbidities and potential predisposition for those patients suffering from asthma or diabetes to develop the other provides an opportunity to maximise early detection and increase the effectiveness of current treatment. Early detection of both is essential in allowing vital interventions to take place that can improve health outcomes. Aim: Ascertain whether the prehospital treatment of acute asthma exacerbation with nebulised Salbutamol results in increased blood glucose levels that may be used as treatment markers. Method: All pre-coded asthma calls were collated over a 12-month period from one UK ambulance service. These calls were filtered to identify those where nebulised Salbutamol was used as part of their treatment, with a particular focus on those patients that demonstrated a post nebulisation blood glucose level of above 5.5 mmol/L, or any increase between pre and post levels. Results: Over the timeframe ambulance clinicians administered nebulised Salbutamol to a total of 1,465 asthma patients. Of these 1,134 (77%) had their blood glucose recorded at least once, with 241 (13%) demonstrating a post nebulisation level in excess of 5.5 mmol/l. Where a pre and post blood glucose measurement was taken 92 (8%) patients showed a rise in their levels. In total where a post nebulisation measurement was taken 106 (9%) patients demonstrated a level of 10 mmol/l or above. Conclusion: The potential for asthmatics to have an underlying predisposition for diabetes and need for further development is highlighted by the number of patients that demonstrated a high or increase in blood glucose levels following nebulisation.