Study shows diabetes patients are most motivated persons 

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A quick post regarding an exciting study that dropped today in the release of Virta Health’s one year data on the impact their intensive lifestyle counselling, coupled with their ketotic diet, had on patients with type 2 diabetes.
The results were impressive.
Of the 262 patients who started the year long study, 83% finished, and of those their metabolic biomarkers and weight improved dramatically. On average their hemoglobin A1C (a long term measure of blood sugar) dropped from 7.6 to 6.3, type 2 diabetes medications other than metfromin dropped from 56.9% to 29.7%, and insulin was reduced or eliminated in 94% of subjects who started out on insulin, while sulfonylureas were eliminated entirely. Weight dropped an average of 30lbs. Insulin resistance as measured by HOMA-IR dropped by 55%, hs-CRP by 39%, and triglycerides by 24%. Though LDL did rise by 10%, HDL rose by 18% and apolipoprotein B was unchanged.
All this to say that if you have type 2 diabetes, and you’re motivated to make lifestyle changes, Virta health’s program definitely appears to be worth considering.
But there are some caveats.
Firstly the study looked at individuals who self-identified as wanting to affect lifestyle change, and so their comparison with “usual care”, which consisted of individuals identified by their MDs as having diabetes and then being relegated to their local diabetes education program, may not be a fair one.
Secondly, the intervention was incredibly robust and intensive. That’s not a knock. I think it’s terrific. It included,
“continuous care through intensive, digitally-enabled support including telemedicine access to a medical provider (physician or nurse practitioner), health coaching, nutrition and behavior change education and individualized care plans, biometric feedback, and peer support via an online community”
And where behaviour change techniques taught included,
“education of natural consequences, shaping knowledge, goal setting, self-monitoring, feedback, monitoring and reinforcement from health coach and medical provider, self-belief, social support, relapse prevention, associations, and repetition”
Patients were provided a cellular connected body weight scale, a glucometer and ketometer, and a bp cuff. Patients were then given access to a web-based application to input data and where they received monitoring, education, and communication with their team.
Food wise participants reported daily hunger, cravings, energy, and mood by way of a Likert scale and health coaches worked with patients individually to adjust intake.
It is notable that daily protein intake was targeted to 1.5g/kg, and also that their weight losses had pretty much leveled off by year’s end.
I bring up the robust intervention only in that I’m not aware of any prior interventions with other dietary strategies that would compare and therefore at this point it’s difficult to divvy up what percentage of outcomes relate to the intensity and frequency of the intervention, and what percentage to their high protein, low-carb, ketotic diet.
The cost of Virta Health (if not covered by your insurer), is reported by them to be (I have no affiliation BTW) $400/month, but given the cost of diabetes medications and the outcomes reported herein, those costs may well be offset by your results.

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