Effects of Lactulose on Gut Microbiota and Metabolism in Diabetic Constipated Patients

Inclusion Criteria

• •Age: 18-70 years
• •Type 2 Diabetes Diagnosis (per 2017 ADA criteria), meeting ≥1 of:
• •1. Fasting plasma glucose (FPG) ≥7.0 mmol/L
• •2. hour plasma glucose ≥11.1 mmol/L during 75g anhydrous oral glucose tolerance test (OGTT)
• •3. Random plasma glucose ≥11.1 mmol/L with hyperglycemia symptoms or hyperglycemic crisis
• •Functional Constipation (Rome IV criteria), requiring:
• •1. ≥2 of the following
• •1. occurring in ≥25% of defecations
• •2. Straining
• •3. Lumpy/hard stools (Bristol Stool Scale 1-2)
• •4. Sensation of incomplete evacuation
• •5. Anorectal obstruction/blockage
• •6. Manual maneuvers required
• •7. \<3 spontaneous bowel movements/week
• •2. No loose stools without laxatives
• •3. Exclusion of IBS diagnosis. Symptom duration \>6 months, with active symptoms meeting criteria for last 3 months.
• •Stable Glycemic Control: No anticipated antidiabetic medication adjustments during study
• •Dietary Stability: Maintain consistent diet; avoid yogurt, fermented foods, prebiotic-containing processed foods, or other items that may confound results