Lactulose and Diabetes

[Crafter1950]

Has anyone had the additional diagnosis of diabetes? My question is because my 42 year old daughter with multiple disabilities takes Lactulose and Xifaxin. About mid March her diet controlled blood sugar started rising. In looking at her files I see a change in brand occurred about 3 weeks before the rise. It’s been a really difficult year with a hysterectomy 9 months ago and other blood work rising. We can deal with the 2-3 poos per day but rising blood sugar and now on a Diabetes med for the first time in 12 years is wearing this 69 year old mama out.

[LAJ123]

Hi Crafter1950,

When I was diagnosed with cirrhosis, it was almost immediately followed by a diagnosis of diabetes.

I had quite severe hepatic encephalopathy so was, like your daughter on Rifaxamin and large doses of lactulose. The diabetic nurse specialist assured me that there wasn't a problem with lactulose because, although it is a form of 'sugar', it is only effective within the gut and is not absorbed into the circulation where it might be a problem. This is because the molecules are large and don't cross into the blood stream from the gut. However, if you are concerned and your daughters blood glucose levels are not as well controlled as before, she needs to discuss this with her own doctor or consultant to make sure that she's getting the right treatment and care.

Hope this helps.

Jim

[Crafter1950 in reply to LAJ123]

Thank you for the reply. I am gathering info about this to talk with her GI. Interestingly, when I have read about testing with Lactulose they don’t accept those with diabetes. She doesn’t talk and can’t tell us how she feels. I am in charge of her food, but she watches for that moment when, I, her dad or care provider turns away and then food disappears. I’ve done this for 42 years and will continue my advocacy.

[LAJ123 in reply to Crafter1950]

Hi,

I do understand how difficult it is for you and you are right to question the use of lactulose when she has diabetes. Despite her finding it difficult to let you know how she is feeling I'm sure that you notice the subtle changes that others wouldn't be aware of.

Don't forget to take care of yourself as well.

Jim

[Hidden]

Hi Crafter

I had and still have diabetes 2 before my TP and after my TP. Pre thenTP as my cirrhosis progressed and the frequency of HE episodes increased I took more and more lactulose (as directed). This was in addition to Rifaximin (cirrohsis) and Metformin (diabetes). My BSL levels started to rise. I had a meeting arranged with the diabetes nurse to discuss the addition of insulin injections but then I got the TP call just a few days before the appointment.

So the fix for me was going to be insulin injections. (As it turns out post TP your BSL can rise so I was put on insulin anyway. - Now stopped though).

In answer then, your daughter may be put on insulin. I’m not a doctor so can’t say for sure obviously, but that has just been my experience.

Good luck to you both.

Miles

[Crafter1950 in reply to Hidden]

Thank you for sharing your experience. It helps me confirm that my daughter’s GI and PCP and I have to discuss this thoroughly. In the meantime I am taking some renewal diabetes education classes.