Can diabetic patients with constipation use lactulose? Will it increase blood sugar?

A friend with diabetes told Huazi that he had constipation recently and the doctor prescribed lactulose for him. Because the drug name contains "sugar", he was worried that it would affect his blood sugar. He asked the doctor, but he didn't understand some of the terms. However, the doctor was too busy and he was embarrassed to ask more questions, so he came to consult Huazi.

Huazi said that lactulose is a commonly used drug for treating chronic constipation. It can also lower blood ammonia levels and is used to prevent and treat hepatic coma. It has good safety and will not increase blood sugar when used normally. It can be used by diabetic patients .

1. Lactulose does not exist in nature

Lactulose is different from the sugars we are familiar with, such as sucrose, maltose, fructose, glucose, etc. It is a synthetic disaccharide composed of galactose and fructose . Lactulose does not exist in nature, so organisms lack the enzyme to break down lactulose.

The same is true for humans. The human body cannot break down lactulose , and can only absorb monosaccharides, not disaccharides. This means that after oral administration of lactulose, it can only remain in the intestines and cannot be absorbed into the blood. Therefore, taking lactulose will not increase blood sugar .

Lactulose promotes the proliferation of beneficial bacteria in the intestines and is decomposed into lactic acid, acetic acid, hydrogen and methane by intestinal bacteria, which increases the osmotic pressure in the intestines, produces water absorption to soften stool, stimulates colon peristalsis, and relieves constipation. Lactulose can also reduce the absorption of ammonia ions in the intestines and reduce blood ammonia levels .

2. Pay attention to the dosage

When using lactulose to treat constipation, it is important to note that the usual daily dose of 30 ml should be taken at one time . Some patients worry that the drug will have a bad effect on the body, so they take 30 ml in three doses, which will affect the efficacy of the drug. After the constipation symptoms are relieved, the maintenance dose is 10-25 ml per day, which should also be taken at one time, and should not be taken separately.

If you want to prevent or treat hepatic coma, you need to take large doses of lactulose, 30ml~50ml each time, 3 times a day.

Regarding the choice of taking time, it is recommended to take it at breakfast. Some patients experience abdominal distension and abdominal pain when taking the medicine on an empty stomach. Taking the medicine after breakfast can alleviate gastrointestinal reactions . It is not recommended to take lactulose before bedtime to avoid nighttime bowel movements that affect sleep.

3. Precautions for taking lactulose

1. Maximum dose : When used to treat constipation, it is not recommended to exceed 45ml per day . Excessive doses will not improve the drug effect, but will easily cause gastrointestinal reactions. Large doses are only required when used to prevent and treat hepatic coma.

2. Long-term use is not recommended : Lactulose is an osmotic laxative. The possibility of drug dependence is low in short-term use, but in long-term use, once the drug is stopped, constipation symptoms may recur. Therefore , while taking lactulose, it is necessary to combine diet and exercise to relieve constipation , and gradually reduce the dosage, and do not rely on drugs for a long time.

3. Adverse reactions : You may experience abdominal distension and pain in the early stage of taking the drug, which usually disappears after continuous treatment. The drug contains lactose and galactose, so it is contraindicated for people with lactose intolerance, galactosemia, and allergies .

4. Stop the medication if the effect is not good : Generally, lactulose will show its effect within 1-2 days after taking it, and soft stools will be discharged. If the constipation symptoms are still not relieved after taking it for 3 days, stop the medication and see a doctor . It is necessary to rule out organic lesions such as digestive tract tumors and intestinal obstruction, and change the medication under the guidance of a doctor.

4. Lifestyle intervention to improve constipation

The high blood sugar level in diabetic patients will absorb water from the intestines, causing dry stools. Excessive blood sugar levels may also lead to peripheral neuropathy, affecting the function of intestinal nerves and making constipation more likely. Therefore, in addition to taking medication to control blood sugar and relieve constipation symptoms, diabetic patients should also improve constipation through lifestyle intervention methods .

Drink enough water every day. For people with normal heart and kidney function, it is recommended to drink more than 2000ml of water every day ; choose more foods rich in dietary fiber, such as coarse grains and vegetables; insist on exercising and taking a walk about 1 hour after a meal, which can not only lower blood sugar but also promote intestinal peristalsis; develop the habit of regular bowel movements , and do not read or play with your phone while defecating.

In summary, if diabetic patients have constipation, they can use lactulose to relieve symptoms, which will not increase blood sugar. When taking the medicine, pay attention to taking the daily dose at one time, but do not take an overdose. While taking the medicine, you should intervene in your life to improve constipation. Long-term medication is not recommended to avoid dependence. The medicine must be used under the guidance of a doctor. If you have any questions about the use of the medicine, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.