Durian Consumption in Adults With Type 2 Diabetes Mellitus

Official title

Durian Consumption on Human Microbiome and Metabolome in Adults With Type 2 Diabetes Mellitus (DURIOME-T2D)

Overview

This single-arm clinical trial investigates the effects of daily durian consumption on the gut microbiome, host metabolome, and glucose metrics in adults with type 2 diabetes mellitus (T2DM). Forty adults with T2DM will undergo a pre-durian phase, a durian consumption phase, and a post-durian phase, each lasting 10 to 14 days. Participants will attend five visits at Singapore General Hospital for clinical assessments, continuous glucose monitoring, fasting blood collection, stool sample collection, and dietary and stool record submission. The study aims to determine whether durian consumption alters microbiome and metabolomic profiles and whether it affects glycemic measures in adults with T2DM.

Detailed description

Durian is a widely consumed tropical fruit with high fiber content and multiple bioactive compounds, including phenolics, flavonoids, carotenoids, and volatile sulfur compounds. Although animal and limited human studies suggest possible metabolic effects, the impact of durian consumption on gut microbiota and host metabolomic profiles in adults with type 2 diabetes mellitus remains unclear. This single-arm interventional study will enroll 40 adults with T2DM at Singapore General Hospital. Participants will complete five study visits over approximately 1.5 to 3 months. After screening, eligible participants will enter a pre-durian phase, a durian phase, and a post-durian phase, each lasting 10 to 14 days. During the durian phase, participants will consume 100 g of durian on Day 1 and 200 g daily from Day 2 onward for 10 to 14 days. Continuous glucose monitoring will be performed across study phases. Blood samples will be analyzed for clinical laboratory parameters, inflammatory markers, metabolomics, and genetic/epigenetic analyses. Stool samples will undergo metagenomic sequencing and metabolomic analysis. The study hypothesis is that durian consumption will result in significant changes in the gut microbiome and metabolome of individuals with T2DM without adversely affecting gluometric measures.

Interventions

• Dietary supplement Durian pulp
  Fresh durian pulp supplied by the study team. Participants consume 100 g on Day 1, then 200 g daily from Day 2 onward during the durian phase for 10 to 14 days. Participants record the timing and amount consumed each day.

Primary outcome measures

• Change in gut microbiome composition following durian consumption [Time frame: Baseline to end of durian phase, approximately 10 to 14 days; and through post-durian phase, approximately 20 to 28 days from baseline phase start]
• Change in plasma metabolomic profile following durian consumption [Time frame: Baseline to end of durian phase, approximately 10 to 14 days; and through post-durian phase, approximately 20 to 28 days from baseline phase start]
• Change in glucose metrics during and after durian consumption [Time frame: During pre-durian, durian, and post-durian phases, each approximately 10 to 14 days]

Secondary outcome measures (3)

• Change in fasting plasma glucose [Time frame: Baseline to end of durian phase, approximately 10 to 14 days; and through post-durian phase, approximately 20 to 28 days from baseline phase start]
• Change in fasting insulin [Time frame: Baseline to end of durian phase, approximately 10 to 14 days; and through post-durian phase, approximately 20 to 28 days from baseline phase start]
• Change in lipid profile [Time frame: Baseline to end of durian phase, approximately 10 to 14 days; and through post-durian phase, approximately 20 to 28 days from baseline phase start]

Eligibility criteria

Inclusion criteria

• Age 21 to 70 years.
• Diagnosis of type 2 diabetes mellitus.
• Agrees to consume durian for 2 weeks.
• Body mass index 25 to 40 kg/m².

Exclusion criteria

• Known or suspected intolerance or allergy to durian.
• Known skin reaction to adhesives used in a continuous glucose sensor.
• Uncontrolled diabetes (HbA1c greater than 8.5%).
• Severe hypertriglyceridemia (triglycerides greater than 4.5 mmol/L).
• Smoking.
• Previous gastrointestinal surgeries, including cholecystectomy, gastrectomy, bariatric surgery, or colectomy.
• Inflammatory bowel disease.
• Glomerular filtration rate less than 30 mL/min.
• ALT greater than 3 times upper limit of normal.
• AST greater than 3 times upper limit of normal.
• Liver cirrhosis.
• Significant alcohol consumption, defined as more than 20 g/day for women and more than 30 g/day for men.
• Pregnant, breastfeeding, or intending to conceive during the study.
• Current hemorrhoids or piles causing rectal bleeding during stool passage.
• Systemic steroid use.
• Insulin use.
• Weight loss medications, including GLP-1 receptor agonists, orlistat, or phentermine.
• Antibiotic, prebiotic, probiotic, vitamin C, or traditional Chinese medicine use in the last 1 month.
• Uncontrolled thyroid disease.
• Any factor likely to limit adherence to study protocol, including dementia, substance abuse, poor appointment adherence, or family concerns regarding participation

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Basic science

Study locations

Singapore · 1 center

• Singapore General Hospital — Singapore

Identifiers

NCT: NCT07697612 · DURIOME-T2D-01 · 2025-1745

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗