​When Mr B K Iyer, a retired banker and avid tennis player, heard about a research study to ascertain the effectiveness of intermittent fasting as a possible diet therapy for diabetes, it piqued his interest as he had been diagnosed with Type 2 Diabetes Mellitus some years ago. 

The study is conducted by the SingHealth Duke-NUS Family Medicine Academic Clinical Programme (FM ACP) and led by Associate Professor Lee Kheng Hock, Senior Consultant, Family Medicine and Continuing Care, Singapore General Hospital and Deputy Chair, FM ACP. 

Even though Mr Iyer did not meet the necessary criteria to qualify as a study participant, he remained keen to support the study.

“My own experience taught me that to lead a long and healthy life, free of chronic ailments, we need to adopt good lifestyle habits, which include watching our diets, exercising regularly and reducing stress. So when I heard about this research study which could encourage people to bring about positive changes in their lifestyle, I wanted to support it,” shared Mr Iyer. 

His support came as a $30,000 gift to the FM ACP to partially fund the cost of Assoc Prof Lee’s pilot research study. The project began in July 2018 with a research grant from Duke-NUS Medical School.

“The recruitment for this study was slow, as we had to follow very stringent criteria. The COVID-19 pandemic had prolonged the patient recruitment process and we were incurring increased operating costs,” said Assoc Prof Lee. “We had recruited 31 out of the target of 50 patients, and only had funding to recruit five new patients. Mr Iyer’s support came in at this crucial time, enabling us to complete our patient recruitment and see this study through.”

Motivated by his own account of how making certain lifestyle changes led to positive health effects, Mr Iyer hopes his gift could play a part to benefit the wider community.

About the study

The most common form of Diabetes Mellitus is Type 2, caused by the cells in the body resisting insulin, even though the body is producing lots of it, often at very high levels. 

“When we eat round the clock, our body produces high levels of insulin round the clock. This constant high level of insulin is harmful and can result in the cells developing resistance to insulin,” said Assoc Prof Lee. 

Currently, oral medication is used to help the body produce even more insulin to overcome the resistance of the cells. When this fails, insulin is injected into the body. Medication can reduce the high sugar levels in the blood and reduce insulin resistance, but it is usually insufficient because the insulin resistance of patients continues to increase as the disease progresses. 

Assoc Prof Lee explained that insulin resistance is generally caused by lifestyle habits so the best treatment is to adopt a lifestyle that reduces insulin resistance. What we know is that food rich in carbohydrates, especially those that are refined, sweet and starchy are the most harmful in terms of aggravating insulin resistance. Exercise is proven to be more effective in reducing insulin resistance than any drug.  

“Our theory is that restricting the time of eating or intermittent fasting may reduce insulin resistance by relieving the stress of having constantly high levels of insulin circulating in the body. This theory can potentially can lead to a simple and effective addition to our lifestyle interventions,” shared Assoc Prof Lee, adding that the theory is not proven, and hence his research will help determine its efficacy and if so, the best way to implement it. 

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