This guide for healthcare practitioners stems from several position statements from the American Diabetes Association, as well as a consensus report, and Standards of Medical Care in Diabetes publications from 2019 and 2020. All suggest that utilizing a low carbohydrate or ketogenic diet can help reduce HbA1C and reduce medications in persons with type 2 diabetes.

The 2022 ADA Standards of Medical Care publication also states that in individuals with type 2 diabetes who are not meeting glucose targets or require glucose-lowering drugs, low carbohydrate or very low carbohydrate eating plans are a sustainable option. This is a significant change from the previous guidelines, which stated that low carbohydrate diets were not recommended as they eliminated many foods making the diet less palatable, implying that people would have difficulty with compliance to the diet.

This change also comes on the heels of the Mayo Clinic recently recognizing low carbohydrate diets as an alternative for patients with diabetes. The new Mayo Clinic Diet offers meal plans for clients including ‘Healthy Keto meals. This 180-degree shift in thinking about treating diabetes, as well as other comorbidities, is HUGE as it expands the way the medical community thinks about treatment.

The Science Behind Low Carb Diets for Treating Diabetes

Virta Health has been publishing science papers and abstracts demonstrating diabetes reversal and deprescription utilizing a low carbohydrate lifestyle for several years. In their latest abstract, outcomes from their landmark 5-year study have shown evidence that treating type 2 diabetes with a low carbohydrate diet is sustainable and can reverse this condition.

One fifth of the 169 patients in this five-year study experienced full remission of their diabetes, and one-third of patients achieved HbA1c below 6.5% without any diabetes medications, or only requiring Metformin. In addition, there were improvements in weight as well as other biomarkers, such as insulin levels.

From the two-year mark to the five-year mark, they had a 72.2% retention rate, which is incredible. These outcomes of improved glycemic control, weight loss, and retention on a very low carbohydrate diet provide even more validity for this type of eating plan for individuals with type 2 diabetes.

History of Recommended Diet Plans for Diabetics

The creation of this guide is a big step in the right direction by recognizing the benefits of low carbohydrate diets for the reversal of type 2 diabetes. This is a paradigm shift in the way of thinking that nutrition therapy for the treatment of diabetes is a “one size fits all” type of eating plan, as this mentality does not seem to be effective. Nutrition eating plans should be tailored to each specific patient’s goals.

The use of medical nutrition therapy with the plate method, described as half of the plate filled with non-starchy vegetables, one quarter of the plate is protein, and the last quarter is carbohydrate foods, does not seem to be as effective for reversal of diabetes as demonstrated by the continued growth of this condition. In a 2017 randomized controlled trial, the traditional plate method diet was compared with a very low carbohydrate diet. The outcomes showed that patients on the very low carbohydrate diet improved their glycemic control and lost more weight than the plate method group.

The low carbohydrate eating plan is one of the most studied eating plans for type 2 diabetes and has been shown to reduce A1C and reduce diabetic medications. This guide is an excellent starting place for healthcare providers to begin their education regarding this type of eating plan for their patients with type 2 diabetes.

Shortcomings of the ADA Guide

Although the publication of this guide is exciting progress, it is important to note that there are some inconsistencies and sections that need further explanation. It would be ideal for this guide to be reviewed in more detail by additional experts in the low carbohydrate community to provide more clarification for healthcare practitioners preparing to utilize it.

The authors suggest counting total carbohydrates instead of net carbohydrates.

Per the guide, total carbohydrate counting is recommended for maximal weight loss and blood glucose improvement. However, the food lists in the guide should still have fiber listed for patients who choose to count net carbohydrates.

For example, the guide reads that in a half-cup serving, blackberries have 10 grams of total carbohydrates, which would be half of the total days’ worth of carbohydrates for a patient following a very low carbohydrate diet. This could potentially discourage one from choosing blackberries as a food to incorporate into the diet. However, per the USDA half a cup of blackberries has 4.3 grams of net carbs, which would be much more reasonable to incorporate into a diet plan.

The very low carbohydrate non-starchy vegetable list states that all of the foods listed have less than 5 grams of carbohydrates per serving. However, this is not true. They have less than 5 grams of NET carbs but not total. It should be specified more clearly.

Maintaining a total carbohydrate goal of 20 grams of total carbs for 3 to 12 months is extremely difficult for most people to adhere to.

There is concern that adults will not be able to sustain that low level of total carbohydrate intake for such a long period of time, which could potentially lead to the discontinuation of the diet plan.  There is also a question as to why such a low level of total carbohydrates is necessary. In a randomized control trial, significant results were achieved for individuals with type 2 diabetes following a diet of 90 grams of total carbohydrates daily. Low carbohydrate options without such strict carbohydrate goals may be more feasible to consider for many individuals, leading to better dietary compliance and results.

The carbohydrate reintroduction phase seems like an old-school Atkins way of practice.

The guide suggests that a patient should add 5 grams of carbohydrates per week until they stop losing weight or start regaining weight. It does not specify if this increase is total carbohydrates or net carbohydrates. Why does weight determine this? What if they have not improved their A1C or deprescribed yet?

Inconsistencies in the types of fats recommended.

The types of fats recommended in the introduction of the guide are appropriate. However, in the food section of the guide, it suggests polyunsaturated fats such as canola oil as well as margarine, which are not generally recommended on a healthy low carbohydrate diet. Some of the information within the guide is inconsistent and therefore could be confusing to individuals new to this type of eating plan.

The guide does not specifically recommend blood ketone testing after the first several days to confirm ketosis.

We know this is important as bioindividuality makes everyone’s ability to get into and stay in ketosis different. Testing ensures you remain in ketosis or provides you with the information to make dietary adjustments. It is important to measure regularly to maintain compliance and it boosts motivation. Urine ketones do not provide the same level of accuracy or reliability as blood ketone measurements. Therefore, blood ketone testing would be especially beneficial for individuals following a low carbohydrate lifestyle, since a person with diabetes will need to adhere to this diet for a long time.

Final Thoughts:

As mentioned, the creation of this guide from the American Diabetes Association is a positive shift in thinking regarding the treatment for the reversal of type 2 diabetes. Virta Health has been studying and practicing this way for years, which has been shown to be significantly beneficial for patient outcomes. There are many clinical studies currently recruiting that support a low carbohydrate eating plan and its impact on type 2 diabetes as well as a variety of other medical conditions. The fact that a major health organization such as the ADA is recognizing the benefits of this type of eating plan is exciting, and we hope there is more to come. It is important to realize how essential medical nutrition therapy is for diabetes management and reversal. The diet should be uniquely tailored to each individual’s needs.

As a registered dietitian in the low carbohydrate space, I find it very promising (albeit a little slow to come) that this professional entity supports a low carbohydrate eating plan to control or reverse diabetes. And I look forward to further research in this area to help those with type 2 diabetes control their blood sugar, decrease medications, decrease weight, and lead a healthier, longer life!

The post Perspectives on the New ADA Guide for Implementing Low Carbohydrate Diets appeared first on KETO-MOJO.

As the scientific evidence accumulates, it’s becoming clear that their methods are sound and their targets could be achievable.

In this profile and overview of the company and their methods, readers will learn details of Virta’s pioneering diabetes reversal method, a summary of results from their clinical trials, and actionable takeaways for better metabolic health for patients and healthcare professionals alike.

What Is Virta Health?

Virta Health is a healthcare technology organization co-founded by CEO Sami Inkinen, Dr. Jeff Volek, and Dr. Stephen Phinney in 2014 with a goal of reversing the diabetes epidemic, which costs US patients and insurance companies $400 billion in healthcare costs each year.

Before founding Virta, Sami Inkinen was a successful entrepreneur and elite competitive athlete. But not long after winning the Ironman 70.3 World Championship for his age group, he was diagnosed with prediabetes. After realizing that the prescription of “eat less and move more” wasn’t working to keep his blood sugar under control, he sought out alternative perspectives on metabolic health, which ultimately led to his partnership with Dr. Volek and Dr. Phinney.

Virta’s business model is centered around delivering results for patients with type 2 diabetes and prediabetes by reducing carbohydrates and supporting behavioral change instead of managing diabetes through medication.

To achieve this, they combine individualized carbohydrate restriction with continuous remote care techniques, which are significantly different from conventional diabetes care:

• Virta’s high-tech and high-touch approach centers around accountability, with frequent contact between patients and providers (including doctors, coaches, and other diabetes experts). Most patients might only see their local doctor once every six months, but Virta health patients can check in daily for guidance and support.
• Conventional diabetes care models rely on local relationships between patients and doctors at local clinics or hospitals. In contrast, Virta Health provides direct services to patients remotely so they can treat any patient in the country at far lower costs. They also work with healthcare providers directly and have successfully negotiated virtual care partnerships with health insurance providers like Blue Cross and Humana, government organizations like the U.S. Department of Veterans Affairs, and employers including US Foods, Comcast, and hundreds of others.

Virta’s diabetes reversal method is radically different from traditional methods for managing diabetes and it is scalable.

The company employs medical doctors, diabetes experts, and clinical researchers. In keeping with their technology roots, Virta also employs data scientists, engineers, and operations managers. Educators, coaches, and outreach specialists round out the team.

Why Virta’s Mission Matters

Type 2 diabetes is a chronic disease characterized by high blood sugar, decreased sensitivity to insulin (the hormone that regulates blood sugar), and an inability to manage or control blood sugar.

Despite massive awareness and prevention campaigns, the prevalence of diabetes continues to rise every decade.

Current mainstream recommendations for preventing and managing diabetes do not seem to be slowing the growth of this disease.

Approximately 34 million Americans live with type 2 diabetes, and another 88 million have prediabetes (defined as A1C or average blood glucose over 3 months of 5.7% to 6.4%) that may develop into full-blown diabetes.

According to an expert panel put together by the American Diabetes Association (ADA), up to 70% of individuals with prediabetes will develop type 2 diabetes. Other evidence suggests the progression rate could be 90% or higher.

Diabetes reduces patient quality of life dramatically and puts individuals at significantly greater risk of heart disease, some cancers, Alzheimer’s dementia, and other health problems.

It’s also associated with significant costs: the average expense to patients is $9,601 per year attributed to diabetes. Their average total medical expenses are $16,752 per year, which are approximately 2.3 times higher than what people without diabetes spend on medical care.

Conventional type 2 diabetes care focuses on managing the disease with medications like insulin, in hopes of preventing its progression, as opposed to curing or reversing it. While diabetes reversal isn’t unheard of with traditional care, the rates are very low — current estimates suggest that only 1 in 50 to 1 in 200 patients are likely to experience diabetes reversal while following conventional diabetes treatment recommendations.

These numbers are bleak, but that’s why Virta’s approach has the potential to revolutionize diabetes prevention and diabetes treatment.

The Results, and Why the Virta Approach is So Successful

In a 2021 peer-reviewed study investigating the Virta method, only 3% of patients progressed to type 2 diabetes over the two-year study period. According to data from the National Institutes of Health, the usual rate of prediabetes-to-diabetes progression over two years with conventional treatment is 22%.

And in Virta’s separate two-year diabetes reversal clinical trial published in 2019, at least 38% of original participants were able to reverse their diabetes using the Virta method. Out of the 74% who completed the two-year trial, a 55% majority successfully reversed diabetes.

Not only that, but most patients achieve rapid diabetes reversal within 10 weeks, then continue to sustain their results at the one- and two-year marks.

They also found that patients stick with Virta at a much higher rate than most other medication or nutritional programs. Patient retention in the Virta program at one year was 83% percent, or between two to six times higher than most other medication or nutritional programs according to peer-reviewed evidence.

Here’s a visual summary of the results of the Virta treatment after one year compared to standard or usual care for type 2 diabetes:

How Does Virta Health Work?

At the individual patient level, Virta’s approach focuses on regular monitoring of blood glucose and ketones paired with dietary goals — specifically, reducing the intake of carbohydrates.

Statistics clearly show that many people with diabetes or prediabetes struggle to monitor blood sugar or follow dietary recommendations consistently, with an overall glucose management success rate of less than 50% for conventional approaches. To help individuals deal with these challenges, Virta builds accountability into their program by requiring regular check-ins and offering ongoing remote patient support outside of traditional doctor’s office settings.

Equally importantly, a sustainable ketogenic diet helps reverse insulin resistance, which addresses the underlying mechanisms of diabetes. Evidence suggests that this type of dietary carbohydrate reduction is the single most effective method of keeping blood sugar under control.

These practices not only result in lower blood glucose, reduced HbA1c (glycated hemoglobin, a marker that’s associated with blood sugar management), and healthy weight loss, but also decrease reliance on diabetes medications by at least 50% overall (and many patients are able to discontinue them altogether), which can ultimately reduce average yearly costs by payer (or employer) over $5000 per patient. They also decrease other health complications associated with diabetes — as long as individuals adhere to the Virta protocol and stay consistent with their new, healthier lifestyle.

Additional reasons for Virta’s success are their nontraditional company structure and novel approach to providing healthcare services. In classic startup fashion, their goal is to disrupt widespread, expensive, and less effective models of diabetes care.

Digging Into the Science Behind Virta Health

Carbohydrate Reduction and Glucose Tolerance

The Virta treatment is practically the opposite of the current mainstream recommendations for people with diabetes, such as the CDC’s position that “On average, people with diabetes should aim to get about half of their calories from carbs.”

In conventional diabetes management, doctors and experts advise patients to “count carbs to match your insulin dose to the amount of carbs in your foods and drinks” and “take additional insulin if your blood sugar is higher than your target when eating.”

While these recommendations are sometimes effective at stabilizing diabetes, it’s also not hard to see why they fail frequently. Not only do patients have to learn to count carbohydrates, but they also have to check blood glucose repeatedly, administer medications or insulin around meals (often using a syringe), measure again, and make any necessary adjustments afterward. Worst of all, for many patients, medication allows them to continue making poor nutritional choices that ultimately lead to disease progression and to do not address the root cause of diabetes itself

Consuming 50% of your calories from carbohydrates during conventional diabetes care is a high daily carb intake. While not all experts today agree on the root causes of diabetes, there is strong evidence that eating lots of carbs and sugar is associated with insulin resistance, which is one of the underlying factors that leads to diabetes as well as progression of the disease.

In contrast, on the Virta Health treatment, individuals typically consume no more than 30-50 grams of daily carbs, which would be a mere 6-10% of calories from carbs on a typical 2,000 calorie diet. To achieve greater compliance, they also monitor blood glucose and ketone levels in real time with specific target goals and receive follow up recommendations from expert coaches as needed.

The behavioral change to a low-carb diet can be challenging for some people, but it’s still less complicated than the conventional approach, which involves carb counting and administering medication to adjust to swings in blood glucose. And because a low-carb diet begins significantly restoring insulin sensitivity as quickly as 4-6 weeks, this way of eating also allows most patients to taper or even stop using their diabetes management medications, including insulin.

Nutritional Ketosis

Similar to the popular weight loss diet, all Virta participants follow a “well-formulated ketogenic diet” and restrict their daily carb intake to 30-50 grams or less.

The ketogenic diet gets its name because this type of carbohydrate reduction results in the production of ketones by the liver, also called nutritional ketosis.

Along with monitoring their glucose levels regularly to safely decrease medication, Virta enrollees also monitor their ketone levels to ensure compliance to the diet using a dual-purpose glucose-ketone monitor like this one.

Research also demonstrates that eating a moderately low-carb diet can be highly beneficial for diabetes, even without achieving nutritional ketosis.

On the Virta Health treatment, patients may experience additional benefits above and beyond regular low-carb diets, including increased weight loss, lower levels of inflammation, better food intake control, and reduced hunger.

Virta Health Study Results: Two-Year Clinical Trial Outcomes

Virta Health has sponsored two in-depth clinical trials investigating their diabetes reversal process, each lasting two years.

The first study, published in 2019, investigated outcomes in people with type 2 diabetes.

And the second, published in 2021, researched the effects of Virta’s program for preventing the progression from prediabetes to diabetes.

Prevention of Prediabetes Progression to Diabetes

In their latest pilot clinical trial published in 2021, Virta used the same ketogenic program they use to reverse type 2 diabetes, but in a slightly different population: people with prediabetes.

Of 96 participants, only 3% progressed to type 2 diabetes over the two-year study period.

While the sample size wasn’t large, these numbers are very promising compared to standard prediabetes treatments. For example, Virta’s results are significantly better than results from the National Institutes of Health Diabetes Prevention Program (NIHDPP) which resulted in higher diabetes progression rates of 8% (and 22% in an NIH control group who received “standard lifestyle” health advice recommendations for people with prediabetes).

Type 2 Diabetes Reversal

In the Virta Health trial published in 2019, 349 patients with type 2 diabetes voluntarily decided whether to try the Virta Treatment or to receive “usual care” for their condition. A total of 262 adults enrolled in the Virta program and 87 adults opted for usual diabetes care.

Of the original 262 participants following the Virta program, of whom some dropped out, an unprecedented 38% were able to sustain diabetes reversal at two years. But of the patients who actually finished the two-year study, an even more remarkable 55% majority successfully reversed diabetes.

Virta defines successful diabetes reversal based on patient levels of HbA1c under 6.5% with no medication besides metformin (a low-potency medication that reduces the amount of sugar the liver releases into the body), or without any diabetes medication at all.

Reduction in Insulin and Other Diabetes Medication

The Virta treatment group in the diabetes reversal trial also achieved:

• • A mean (average) insulin dose reduction of 81% from baseline to 2 years
  • A 61% insulin dose reduction in the group members who remained insulin users at the two-year mark
  • A discontinuation rate of 67% for all diabetes-specific prescriptions including most insulins and all sulfonylureas

Weight Loss and Changes in Other Health Markers

In the prediabetes prevention study, the majority of participants achieved and maintained 5% weight loss by the end of the two-year study.

The diabetes reversal trial found:

• • 10% mean weight loss in the Virta treatment group at 2 years, which was comparable to typical results from gastric banding — without any requirements for restricting food intake or counting calories
  • Sustained improvement of liver enzymes, steatosis (fatty liver), and fibrosis (scar tissue) in the Virta group
  • Reduced visceral fat content for the Virta group
  • Reduced markers of inflammation (hsCRP and white blood cells) in the Virta treatment group

What Are the Potential Shortcomings or Criticisms of These Trials and Methods?

The purpose of early or pilot studies like these is to determine whether a treatment deserves continued study and to learn more about how it works under relatively controlled conditions, so in that sense, both Virta trials to date were highly successful.

But while these studies were designed by experts to give as much information as possible, they still won’t provide as much insight or credibility as larger trials that are funded by third parties.

On the other hand, it’s important to understand some of the unique challenges in the context of Virta’s approach to diabetes reversal.

Randomized controlled trials (RCTs) are widely considered the gold standard in medicine, but because of how Virta’s diabetes treatment works, it’s simply not possible to “blind” patients to treatments or offer a credible placebo as with some experimental methods.

And with a two-year commitment, there’s a case to be made that it wouldn’t be ethical or reasonable to expect patients to stay in a randomly selected treatment group, especially when one treatment method appears to be more effective than the other (as is the case with Virta’s diabetes reversal method).

Looking at the methods themselves, not every Virta treatment patient finished either trial, but neither did all of the usual care patients in the diabetes reversal comparison.

Although the retention rate was slightly lower for Virta treatment (74%) versus the “usual diabetes care” group (87%) at two years, there were no reported adverse events to the intervention or that resulted in discontinuation for Virta patients, including no reported episodes of ketoacidosis or severe hypoglycemia requiring assistance.

It’s also worth noting that “usual care” refers to the standard diabetes treatment model that which only has a diabetes remission rate of 2% or less (some evidence suggests as low as 0.5%, or 1 in 200 patients).

The separate two-year diabetes prevention study published in 2021 showed a similar retention rate of 74% for the Virta group at two years but didn’t include a usual care control group.

Although around a quarter of participants dropped out of the Virta study by the end of the two years, these numbers are still much more promising than most other diabetes prevention programs and behavioral interventions. For example, analyses for the “gold standard” NIH National Diabetes Prevention Program have shown drop-out rates (not retention rates) of 68% at 10 months and 86.8% at one year.

The Important Lessons Everyone Can Learn from Virta Health

Patients with type 2 diabetes, prediabetes or metabolic syndrome, and similar conditions can learn plenty from Virta Health’s methods and study results.

Virta is demonstrating that their novel approach to diabetes prevention and reversal can significantly increase individual quality of life and lifespan, as well as decrease the societal burden of caretaking and associated costs.

Although behavioral support is a significant factor in Virta’s overall success, some people are also capable of following a low-carb keto diet and getting similarly dramatic results on their own or working with their doctor.

Patients with diabetes should consult a doctor well-versed in the ketogenic diet before going keto, especially if they take diabetes management medications.

For healthcare providers and anyone who seeks to improve health outcomes for patients with metabolic conditions, Virta may have even more significant lessons to offer. Their company structure, ambitious goals, and efficient virtual care process are each capable of inspiring success in other areas of healthcare.

Frequently Asked Questions About Virta Health and Diabetes Reversal

Can you reverse Type 2 Diabetes?

According to a two-year study from Virta Health, the answer is yes, it is possible to reverse type 2 diabetes. The study, published in Frontiers in Endocrinology, found that a low-carb ketogenic diet reversed diabetes in 38% of all patients who enrolled in Virta treatment and 55% of patients who completed the study.

What is the Virta program?

The Virta Health diabetes reversal program combines an individually tailored, low-carb keto diet with a novel approach to patient education, support, and remote monitoring. Virta refers to their approach as continuous remote care with behavioral change. Evidence shows it’s not only effective for reversing diabetes, but also prediabetes.

What does Virta health cost?

For patients paying out of pocket, Virta costs $249 per month with a one-time $250 charge for their Starter Kit which includes a blood glucose and ketone monitoring system. Patients could save around $5,000 per year on medication costs.

Some insurance companies cover 100% of Virta costs for plan holders, and some forward-thinking companies are even covering Virta costs for their employees. In both cases, Virta’s proven methods for preventing and reversing diabetes can substantially reduce medical costs for payers and groups.

Virta encourages health plan leaders and employers to contact them and discuss partnerships.

How do you enroll in Virta health?

Patients with type 2 diabetes and some related conditions can enroll in Virta Health by visiting their patient signup page. From there you’ll submit an application, meet an enrollment advisor, go through a medical screening process, meet with a physician, and begin a personalized treatment plan.

​​Keto-Mojo is a proud partner with Virta Health, providing them with state-of-the-art blood glucose and ketone meters for their patients and clinical research for diabetes reversal treatment. Our metabolic monitoring systems are trusted by world-class experts and available without a prescription for under $50, including everything you need to get started.

The post Virta Health Is Reversing Diabetes, Saving Lives, and Saving Healthcare Costs appeared first on KETO-MOJO.

The Problem of Type 2 Diabetes

Type 2 diabetes is marked by high blood sugar, high insulin, high blood pressure, high triglycerides, and obesity—all risk factors for chronic disease. Specifically, type 2 diabetes increases the risk of heart disease, cancer, Alzheimer’s, and—unsurprisingly—death.

Worldwide, there are about 380 million cases of type 2 diabetes. This wasn’t always the case. In the US, for instance, rates of diabetes have increased by a factor of seven in the past fifty years. Why? American diets and lifestyles have changed. Americans now eat more sugar and move less frequently than ever before. These changes are driving the diabetes epidemic. Unlike type 1 diabetes—which results from autoimmunity in the pancreas—type 2 diabetes is largely lifestyle driven. 

Here’s how type 2 diabetes develops:

• • A high-carb diet combined with a sedentary lifestyle leads to high blood-sugar levels (hyperglycemia).
  • Hyperglycemia provokes the release of insulin, resulting in high insulin levels (hyperinsulinemia).
  • Hyperinsulinemia promotes weight gain because insulin is an energy storage hormone.
  • Hyperinsulinemia also creates insulin resistance, the underlying metabolic issue in type 2 diabetes.

Insulin Resistance and Its Role in Type 2 Diabetes

Insulin resistance refers to a desensitization of insulin—an impaired ability of this hormone to store blood-sugar in muscle and liver cells. Insulin resistance creates a feedback loop. The pancreas produces more insulin to handle the same blood-sugar load, insulin resistance worsens, more insulin is churned out, and the cycle continues. Eventually, type 2 diabetics lose their ability to make insulin, and supplemental insulin is needed to prevent hyperglycemia.

To reverse diabetes, the insulin resistance loop needs to be broken. The ketogenic diet can help.

How the Ketogenic Diet Helps with Diabetes

The ketogenic diet requires you eat a certain number of daily calories based on personal factors like weight, age, activity level, etcetera. But not just any calories. The critical piece to the keto diet is the types of calories you consume. Specifically, you need to divide the daily calories into consumption of 70 to 75 percent fat, 20 to 25 percent protein, and 5 to 10 percent carbohydrates. 

Eating fat, protein, and carbs in these proportions keeps blood sugar and insulin levels low. In turn, low insulin signals the liver to beta-oxidize (break down) fatty acids and produce ketones.

Ketones, like glucose, can be used by cells (especially brain cells) to make energy in the form of adenosine triphosphate (ATP). The ketones are produced when the body recognizes it doesn’t have glucose to use for energy. When the body produces and uses ketones rather than glucose for fuel, this is a state called ketosis, which is a survival mechanism and backup energy program used in times of glucose scarcity. 

Ketosis is also an antidote for the Standard American Diet (SAD). By eliminating carbs, the ketogenic diet does an about-face to the SAD and in doing so eliminates a major driver of diabetes (carbs/sugar).

The keto diet helps change the type 2 diabetic tides by addressing its causes:

• Weight loss

Weight loss through calorie restriction is a pillar of current diabetes treatment. Unfortunately, the method of simply losing weight hasn’t been very effective for people with type 2 diabetes.

Why not? For one, because calorie restriction lowers basal metabolic rate. When normal portions are resumed, energy expenditure stays low and the weight comes back.

The keto diet may be a better option. For instance, one study found that healthy women on keto lost more weight than women on a calorie-restricted diet.

Also, high-fat diets reduce appetite-stimulating hormones like ghrelin and neuropeptide Y. These hormonal shifts prevent overeating and enable sustainable weight loss.

• Less carbohydrates

The main clinical indicator of type 2 diabetes is high blood sugar. This is usually measured by fasting blood glucose or HbA1c, a measure of average blood glucose. Carbohydrates are the main culprit elevating blood sugar. Researchers have found that high-carb diets exacerbate hyperglycemia in non-insulin dependent diabetics.  A ketogenic diet restricts carbohydrate intake through its recommended macronutrients or “macros” (daily recommended caloric intake broken down into percentages of fat, protein, and carbs).

Keto diets have been shown, in multiple studies, to significantly lower blood glucose in type 2 diabetics—even to the point of reversing the diagnosis.

• Improved insulin function

Those with advanced type 2 diabetes often need insulin injections to maintain normal blood sugar levels. But insulin therapy is more of a bandaid than a cure, and only worsens the problem of insulin resistance.

The ketogenic diet can break the insulin resistance spiral. Blood sugar stays low, insulin levels drop, and insulin function slowly returns. In a study published in BMC Medicine, the majority of type 2 diabetics enrolled were able to drop their insulin medication after 24 weeks of ketogenic dieting.

A New Model of Diabetes Treatment

The standard model for treating diabetes is shifting. According to a recent consensus report in the journal Diabetes Care, carbohydrate reduction has “the most evidence for reducing glycemia” in those with type 2 diabetes.

Yet challenges remain. For instance, many patients on medications (like metformin or insulin) require medical supervision to prevent dangerous hypoglycemia on a low-carb diet. Finding this supervision isn’t easy. 

A San Francisco-based company called Virta Health has addressed this problem by creating an online, doctor-supervised program for reversing type 2 diabetes. The program is designed, through a series of regular check-ins, to keep patients in nutritional ketosis (0.5 to 3.0 mmol/L). 

Here are some highlights from a one-year controlled study (published in 2018) on 218 type 2 diabetics enrolled in the Virta Health program:

• • 60 percent of patients reversed their diabetes (average HbA1C declined from 7.6 percent to 6.3 percent) 
  • 94% of patients reduced or eliminated insulin therapy
  • Average weight loss was 30.4 pounds
  • Average triglycerides decreased 24 percent

This data demonstrates that a properly-supervised ketogenic diet can reverse diabetes. And more results are surely coming. 

The Final Word

Millions of people have type 2 diabetes. It’s a health crisis driven by high-sugar diets and sedentary lifestyles. 

To treat type 2 diabetes, researchers are increasingly turning to the ketogenic diet. The keto diet promotes weight loss, lowers blood sugar, improves insulin function, and even helps patients get off their medications. 

To achieve therapeutic success, supervision is crucial. Along these lines, Virta Health has developed a remote-care program with proven results. After just one year, a full 60 percent of patients reversed their diabetes through nutritional ketosis.

Results like these show that type 2 diabetes, in many cases, is curable. Perhaps it’s time to roll out this treatment program on a larger scale. 

The post The Ketogenic Diet: Powerful Medicine for Type 2 Diabetes appeared first on KETO-MOJO.

Before that, this new, dramatic step in modern medicine was slowly making its way to the mainstream. In fact, the US government only recently broadened the scope of telehealth services covered by Medicare, the federally-sponsored health insurance program for people 65 or older. But the sudden urgency made the use of telehealth instantaneously widespread, and accepted. Now patients across the country can receive a wide range of remote care services – normal primary care and specialized-medicine office visits, mental health counseling, and preventive care advice – from the comfort of their homes. In cases of required care, it’s covered by most insurance, too. 

So what exactly is “telehealth”? In this article, you’ll learn what telehealth is, the benefits of telehealth, and why it’s quickly becoming an important part of managing and reversing diabetes and obesity and of monitoring your overall health. 

What Is Telehealth?

Telehealth simply refers to healthcare-related activities that are executed online or via phone. But it isn’t just about live phone or video visits with your primary care physician or specialist. It also encompasses a growing array of at-home technology – apps, devices, and wearables – that track your vital health information, can transmit any gathered data to your healthcare providers, and help your providers make more informed healthcare decisions. Telehealth could be:

• A doctor consulting with a patient on a video call
• The ability to directly contact and have email exchanges with your physician through an online portal
• The monitoring of vitals and biomarkers through wearables, devices, and apps
• The online exchange of test results between healthcare facilities
• Two physicians discussing a medical matter via online chat
• A neurologist monitoring potential stroke patients from afar using “telestroke” technology
• A remotely controlled robot-assisted surgery
• And much more

Telehealth Terms to Know

Before discussing the benefits of telehealth in more detail, it’s important to define a few key terms. 

• Telehealth: the term used to encompass all digital healthcare activities, including administrative functions.
• Telemedicine: often used as a synonym for telehealth, telemedicine actually refers to specific clinical services provided to patients.
• Remote patient monitoring: the use of digital technology to collect health data (pulse, blood pressure, glucose levels, ketone levels, weight, etc.) from a patient, then transmit that data to healthcare providers for analysis and treatment recommendations.
• Remote coaching: when a patient signs up for remote coaching, they receive health and wellness counseling from a distance. This counseling can be one-on-one coaching with a provider, or via an app.
• API/API integration: API stands for application programming interface, and refers to a set of rules and functions governing how a piece of software works. API integration is the ability of two online systems to communicate with each other and exchange data. The concept of API integration is especially relevant to the success of app-based telehealth programs. API integration ensures your health data (your daily blood pressure, for instance) is securely and accurately transmitted from your testing device to your provider.
  

Telehealth Technology In Action

There are two key benefits to telehealth technology. The first is obvious: You can now connect with your care provider without being in the same room or even the same continent. The second is less obvious but extremely powerful: You can now gather, evaluate, and share with your health care providers your own personal health stats. 

Not sure what we mean? Consider this: with the benefit of digital technology, suddenly even simple home measuring devices, such as a scale, can be a powerful telehealth device. Every time you step on a “smart” scale, it records your current body weight and sends the data to an app on your phone. That data can then be presented to both you and your physician to give a better, fuller picture of your ongoing status and help your provider coach you and make dietary and lifestyle decisions based on real, evolving information. 

Beyond smart scales, there are many other telehealth-friendly apps and devices. These include:

• Wearables like Fitbit devices and the Oura Ring that track sleep, heart rate, and activity levels
• Apps like MDHealth, Doctor On Demand, and Express Care Virtual that connect patients directly with physicians
• Apps like Cronometer, MyFitnessPal, and Carb Manager that track nutrition information like calories and macros 
• Devices like the Keto-Mojo meter that record biomarkers like glucose, ketones, and GKI. 

In fact, ketone and glucose tracking devices are making a big difference in the fight against diabetes. More on that later.  

Consumer Benefits of Telehealth 

As technology advances, the benefits of telehealth continue to manifest. Here are five solid reasons telehealth is an important and very real part of our medical care, present and future:  

#1: Prevents the spread of infectious disease

SARS-CoV-2 (the novel coronavirus) is a highly contagious pathogen that causes a disease called COVID-19. To mitigate the global health consequences of COVID-19, telehealth became a critical means of receiving health care while avoiding the potential exposure to the virus at medical centers. Telehealth allows patients and healthcare professionals to communicate remotely without risking a potentially lethal infection. 

#2: Allows greater access to healthcare

Many people live dozens of miles from a modern healthcare facility, especially in rural areas. With the benefit of technology, however, these people can receive care and counseling at home.

But you don’t have to live in the boondocks to utilize telehealth to your advantage; for example, if you’ve got a sick child at home, a video visit with the physician can help ease minds and provide the best next steps.

Additionally, the ease of use and affordability is proving instrumental in allowing for greater ongoing access to physicians. For example, San Diego, California-based internist and telehealth practitioner Dr. Brian Lenzkes began transitioning to telemedicine upon realizing that without the costs of a large office, abundant staff, and insurance-related red tape, he can offer patients ongoing care and coaching and easy access while charging close to the same amount as a $75 copay – all without involving insurance. An added benefit: “You have the peace of mind that you can always call your doctor. It’s like having AAA,” explains Dr. Lenzkes. 

#3: Saves time

Even if you don’t live too far from your doctor, it’s a schlep to get in and out of a doctor’s appointment. There’s the transportation time, time spent in the waiting room, the intake nurse checkup, the visit itself (often with delays by the physician), and then the journey back to your home or office. This can easily amount to three or more hours to spend about 15 minutes with your doctor. Telehealth eliminates all but the visit itself, so appointments tend to start on time. Needless to say, the time savings add up quickly. 

In the half an hour it takes to come to see me, you can do something else, like go for a walk. – Dr. Tro Kalayjian, New York-based weight loss specialist

Saving time was a big reason that New York-based weight loss specialist Dr. Tro Kalayjian started implementing telehealth into his medical practice. “In the half an hour it takes to come to see me,” he remarks, “You can do something else, like go for a walk.”  Dr. Tro, as he’s known to patients, is mainly focused on helping obese clients lose weight through proper nutrition. (This includes helping folks get started with the keto diet). Dr. Tro has a deeply personal connection to this area, having been obese into his young adult years. Now that he’s lost the weight, he wants to help others do the same, and telehealth is a big part of that.

#4: Engages and motivates patients

In situations where telehealth is used to track your physical status, progress, or both, seeing ongoing results can have a significant effect on your motivation to stick to your goals. Why?  As the old business maxim goes, “What gets measured gets managed.” When you digitally track weight, blood pressure, glucose, ketones, and other biomarkers over time, it creates a sense of accountability. This accountability increases the chance that you will make positive diet and lifestyle changes. Tracking also allows you to see – in real-time – the effects of what you do and eat. Based on this insight, you can adjust your lifestyle accordingly. 

#5: Provides insight to healthcare professionals

The days of the yearly checkup are gone. Telehealth gives doctors and other clinicians a steady stream of data to make better decisions. Suddenly, your health status is a moving picture, not a once-a-year snapshot. For example, if you’re tracking your glucose and your care provider notices your glucose levels ticking upwards, your care provider might schedule a consultation to discuss the causes and ramifications of this trend, including what you can do to lower your glucose and consequently reduce your risk of diabetes. 

Telehealth For Obesity and Diabetes 

Speaking of diabetes, with the aid of apps, devices, and online programs, patients with diabetes, obesity, or both are seeing remarkable progress in reversing these conditions. For instance, having patients measure ketone levels daily, then sharing this data with their provider, provides a level of accountability previously unseen in healthcare. 

In fact, a growing body of research suggests that telehealth-based interventions are effective for treating both diabetes and obesity, which is encouraging, since effectively managing these conditions decreases the risk for nearly every chronic disease.

In one study published in March of 2020, researchers assigned 25 obese people to either a telehealth group (with weekly remote coaching) or a self-directed group. The results? The telehealth group not only complied better with the program – they also lost more weight.

Another analysis found that after four months of app-based health coaching, participants lost 3.23 percent of their total body weight, on average. About one-third of the 763 participants achieved “clinically significant” weight loss, an average of nearly 10 percent total body weight!

Yet the most striking telehealth success is probably that of Virta Health, an online, doctor-supervised program created to manage and reverse type 2 diabetes. The program is designed to keep patients in nutritional ketosis (0.5 to 3.0 mmol/L) by having them eat a ketogenic diet.  

Multiple studies, including one sponsored by Virta Health, have shown a ketogenic diet to be effective diabetes medicine. Here are the results from one year of the Virta Health program on 218 type 2 diabetics:

• 60 percent reversed their diabetes (average HbA1C dropped from 7.6 percent to 6.3 percent) 
• 94 percent reduced or eliminated insulin therapy
• Average weight loss was 30.4 pounds
• Average triglycerides decreased 24 percent

How does Virta Health ensure patients comply with the program? By having them measure ketone levels.

Measuring Ketones In Telehealth

Measuring ketones, and ensuring you stay in ketosis (by consistently keeping your ketones up) is effective diabetes medicine, but only if the patient complies with the high-fat, low-carb regimen of the keto diet. Fortunately, there exists a specific biomarker – the ketone – to track this compliance. Ketones are molecules, produced through fat burning, that serve as a backup energy source to glucose for your body and brain. If your body doesn’t have carbs to burn, it turns to ketones. As evidence continues to build for the keto diet, patients are increasingly measuring ketone levels along with blood glucose levels. (Blood glucose levels indicate one’s progression towards type 2 diabetes). 

A Word from the Keto-Mojo Team about Keto-Mojo Tools and Telehealth

At Keto-Mojo, our aim is to empower you to optimize and manage your health through a healthy ketogenic lifestyle. Since our founding, we have recognized the benefits, importance, and role of telehealth in this pursuit. So, shortly after launching our blood glucose and ketone testing meter, we created an app, integrated APIs and other nifty tools to help you leverage your test results, empower you to better manage your health, and improve your diet and overall well-being. 

Following are all the Keto-Mojo telehealth tools you can use:

The Keto-Mojo meter: Unlike other devices on the market, the Keto-Mojo meter measures both glucose and ketones in an affordable, convenient manner to improve outcomes for patients for weight loss, type 2 diabetes, metabolic syndrome, and other chronic illnesses that benefit from ketosis. Beyond accurate point-in-time measurements, the Keto-Mojo device allows you to:

• Track glucose, ketones, and the glucose-ketone index (GKI) over time with the Keto-Mojo MyMojoHealth app, available free for iOS and Android.
• Sync glucose and ketone data with a smartphone via Bluetooth connectivity.
• Remotely share glucose and ketone data easily with healthcare providers via secure API integration.
• Feel comfortable that your data is secure because the app and servers are HIPAA compliant.

The Keto-Mojo Bluetooth meter: The Keto-Mojo meter is Bluetooth enabled and allows you to instantly sync your blood glucose and ketone test results from your meter to your smartphone. 

The Keto Mojo Classic app for iOS and Android: This app allows you to track and filter your data and upload your readings to select health management platforms, including Apple Health. 

The ability to import or export your readings via CSV file so you can share your readings with any professional via email. In the case that you are not synced with your provider online or able to share data directly from the app, this tool allows you to share the data with anyone with an email address. 

Secure encrypted API (application program interface): If you’re a health professional and would like your EHR (electronic health record) system to connect your patient data automatically, please contact us.  

SDK (Software Development Kit): We’ve developed a software kit so that we can partner strategically with health companies in order to connect natively to other apps. If you have an app and would like to integrate it, please contact us.

The bottom line? The Keto-Mojo meter, through accurate measurement and secure data sharing, helps both individuals and providers achieve therapeutic success with the ketogenic diet. It’s a tool to track metabolic health over time. 

Contact us for a free consultation on integrations with Keto-Mojo glucose, ketone, and GKI readings.

The Final Word

The coronavirus global pandemic kept people home and pushed telehealth into the forefront as a way to safely connect with care providers from the comfort of their own home. Remote care is the new reality and there’s no going back now.  

But telehealth isn’t just about preventing the spread of a contagion. It’s also about increasing access to care, spurring patient engagement, and providing you and doctors better insight into your health. 

With the benefit of telehealth, the world has already made significant strides against obesity and diabetes. As technology improves, telehealth improves along with it. Keto-Mojo provides many tools to empower you to leverage telehealth to your benefit. The pandemic inspiration may be dark, but the future of telehealth is bright. The more technology permeates healthcare, the better healthcare will become. 

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