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Blood Glucose Response After Oral Intake of Lactulose in Mildly Constipated Patients With Diabetes Mellitus Type 2

Registration Number
NCT03666546
Lead Sponsor
Fresenius Kabi
Brief Summary

The objective of the study is to investigate whether lactulose, given orally as powder or liquid, increases blood glucose levels in patients with diabetes mellitus type 2. The dose of lactulose given in the study is normally used for treatment of constipation.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
24
Inclusion Criteria
  1. Patients with non-insulin requiring diabetes mellitus type 2 treated with diet and oral antidiabetics and/or Glucagon-like Peptide 1 receptor agonists

  2. Age: 18-75 years

  3. Female and male

  4. Caucasian

  5. HbA1c ≤ 7.5 %

  6. Stable treatment, i.e. no change in diabetes mellitus related medication within the last 3 months

  7. Mild functional constipation according to modified Rome IV criteria fulfilled for the last 3 months with symptom onset at least 6 months before study start defined as:

    • approx. 3-5 bowel movements per week,
    • of which 1-2 usually cause discomfort e.g., straining, lumpy or hard stools, sensation of incomplete evacuation or anorectal obstructions/blockage
  8. Availability and presence in the trial unit for approx. 4 hours/ week for 4 weeks

  9. Women of childbearing potential must be using a medically approved method of contraception OR women must be postmenopausal for at least 12 months prior to study entry

  10. Signed informed consent form

Exclusion Criteria
  1. Fasting blood glucose <4.4 mmol/L (<80 mg/dL) or >10 mmol/L (>180 mg/dL) (capillary)

  2. BMI <18.5 kg/m² or ≥35 kg/m²

  3. Change in body weight ≥10 % within the last 3 months

  4. Smoker

  5. Major medical or surgical event requiring hospitalization within the last 3 months

  6. Acute gastrointestinal diseases including diarrhea and/or vomiting within the last 2 weeks

  7. Presence of disease or intake of drug(s) / supplements other than antidiabetic treatment influencing digestion and absorption of carbohydrates or bowel habits (intake of laxatives in general allowed with exception see next criterion) (dietary / supplementary fibres allowed if stable dose since 1 month before study start)

  8. Not willing to abstain from laxatives 2 days before the visits 1-4 and up to 24h after visits 1-4

  9. Use of following medication/ supplementation within the last 4 weeks and during the study:

    • Intake of medications other than antidiabetic treatment known to affect glucose tolerance e.g., steroids, protease inhibitors or antipsychotics;
    • Intake of prebiotics or probiotics
    • Chronic intake of substances affecting blood coagulation (e.g. acetylic acid (100 mg as standard prophylactic treatment allowed when dose is stable 1 month prior to screening), anticoagulants, diuretics, thiazides (diuretics and thiazides allowed e.g. for hypertension treatment when dose is stable 1 month prior to screening)), which in the investigator's opinion would impact patient safety
  10. Severe liver, renal or cardiac disease

  11. Hereditary problems of galactose or fructose intolerance, lactase deficiency or glucose-galactose malabsorption

  12. Suspicion of alcohol abuse (defined as an average daily intake of more than one litre of beer per day or equivalent amount of alcohol in other beverages) or drug abuse

  13. Known or suspected allergy to the investigational drug(s) or other components of the study drug(s)

  14. Acute inflammatory bowel disease (ulcerative colitis, Crohn's disease), gastrointestinal obstruction or subocclusive syndrome, perforations or risk of perforation in gastrointestinal tract, abdominal pain of undetermined cause

  15. Known history of human immunodeficiency virus (HIV), hepatitis B and/or C

  16. Pregnancy, lactation

  17. Clinically relevant findings as established by medical history, physical examination, clinical laboratory and/or vital signs

  18. Participation in another interventional study with an investigational drug or an investigational medical device within 30 days prior to start of study or during the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Laevolac crystals 30 gLactulose crystals 30 gLactulose crystals, oral intake, 30 g single dose
WaterStill waterStill water, oral intake, 250 mL single dose
Laevolac crystals 20 gLactulose crystals 20 gLactulose crystals, oral intake, 20 g single dose
Laevolac liquid 20 gLactulose liquid 20 gLactulose liquid, oral intake, 20 g single dose
Laevolac liquid 30 gLactulose liquid 30 gLactulose liquid, oral intake, 30 g single dose
Glucose 30 gGlucoseGlucose Monohydrate, oral intake, 33 g single dose
Primary Outcome Measures
NameTimeMethod
Capillary blood glucose levels as baseline corrected AUC: AUCbaseline_c (0-180 minutes) [Baseline corrected area under curve from 0 to 180 minutes for blood glucose concentration (= Area under curve from 0 to 180 minutes minus baseline*180 minutes)]0 - 180 minutes, during 4 study visits
Secondary Outcome Measures
NameTimeMethod
Maximum blood glucose concentration (Cmax)0 - 180 minutes, during 4 study visits
Time to reach maximum blood glucose concentration (Tmax)0 - 180 minutes, during 4 study visits
Maximum increase of blood glucose concentration (Max_increase)0 - 180 minutes, during 4 study visits
Relative maximum increase of blood glucose concentration (Max_increase_rel)0 - 180 minutes, during 4 study visits
Total area under curve from 0 to 180 minutes for blood glucose concentration (AUC(0-180 minutes))0 - 180 minutes, during 4 study visits
Incremental area under curve from 0 to 180 minutes for blood glucose concentration, i.e., above baseline levels for blood glucose concentration after oral intake of Laevolac crystals/liquid or control products (iAUC(0-180min))0 - 180 minutes, during 4 study visits

Trial Locations

Locations (1)

Clinical Research Center (CRC)

🇦🇹

Graz, Austria

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