Can patients with high blood sugar take lactulose?

Lactulose is a synthetic disaccharide—not a fructose—and possesses unique pharmacological properties. It is widely used in Western medicine primarily as an osmotic laxative for the treatment of various chronic and habitual constipations. However, lactulose does have contraindications for certain populations. So, can individuals with elevated blood glucose levels (e.g., diabetic patients) safely take lactulose?

Can patients with high blood glucose take lactulose?

Yes, patients with diabetes may safely use lactulose. Clinically, lactulose is employed specifically for its intestinal lubricating and laxative effects—making it especially suitable for diabetic patients who also suffer from constipation.

Among antidiabetic medications, biguanides—such as metformin (brand name: Glucophage)—are considered the cornerstone therapy and are recommended as first-line agents. Their glucose-lowering effect does not cause hypoglycemia. In addition to glycemic control, biguanides confer cardiovascular protective benefits—including lipid regulation and inhibition of platelet aggregation. Mechanistically, they enhance peripheral tissue uptake of glucose, suppress hepatic gluconeogenesis and glycogenolysis, reduce hepatic glucose output, and delay intestinal glucose absorption—thereby effectively lowering blood glucose levels. Another class, alpha-glucosidase inhibitors (e.g., acarbose [Glucobay] and voglibose [Volix]), competitively inhibit enzymes such as maltase, glucoamylase, and sucrase, thereby blocking the hydrolysis of α-1,4-glycosidic bonds. This delays the breakdown of starch, sucrose, and maltose into glucose in the small intestine, resulting in reduced postprandial hyperglycemia.

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