Updated by Franziska Spritzler, RD, CDE, on September 19, 2024 

 

Virta Health (Virta) is a bold company with a goal that may sound unbelievable: to reverse type 2 diabetes in 100 million people by 2025. Over 38 million Americans are afflicted with this disease, along with hundreds of millions more worldwide. Virta’s “moonshot” is to reverse the trajectory of the diabetes epidemic globally. 

What Is Virta Health?

Virta Health is a healthcare technology company founded in 2014 by CEO Sami Inkinen, Dr. Jeff Volek, and Dr. Stephen Phinney. Its mission is to reverse the diabetes epidemic, which costs U.S. patients and insurers $400 billion annually in healthcare expenses.

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. 

In addition to the approximately 38 million Americans living with type 2 diabetes, another 98 million have prediabetes (defined as HbA1c of 5.7% to 6.4%) that may develop into type 2 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.

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

It’s also associated with significant costs. On average, medical expenses for someone with type 2 diabetes are approximately 2.6 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 Virta’s two-year diabetes reversal clinical trial published in 2019, of the 74% participants completed who completed the trial, 55% successfully reversed diabetes. Not only that, but most patients achieved rapid diabetes reversal within 10 weeks, then continued 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, which is unusually high for a nutritional intervention.

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: 

Virta Graph

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 a remarkably effective method of keeping blood sugar under control.

Ketogenic lifestyles not only result in lower blood glucose, reduced HbA1c, and healthy weight loss, but also decrease reliance on diabetes medications by at least 50% overall––with many patients being able to discontinue them altogether––which can reduce average yearly costs by payer (or employer) over $3000 per patient. They may 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 recommend taking additional insulin if blood sugar is above target. 

While these recommendations are sometimes effective at managing 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 must 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 do not address the root cause of diabetes itself. 

Consuming 50% of your calories from carbohydrates is a high daily carb intake for a person with diabetes. While not all experts today agree on the root causes of type 2 diabetes, there is evidence that eating high amounts of sugar and refined carbs 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 very-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.  

Nutritional Ketosis

The ketogenic diet gets its name because eating very few carbohydrates results in the production of ketones by the liver. The main ketone, beta-hydroxybutyrate, can be measured in the blood. Once a person’s beta-hydroxybutyrate levels reach 0.5 mmol/L, they are in a state of 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. 

On the Virta Health treatment, patients may experience additional benefits above and beyond lower blood glucose, including increased weight loss, better food intake control, and reduced inflammation.

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 explored 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 diabetes progression rates of 8% in the intensive lifestyle modification group and 22% in the 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. 262 adults enrolled in the Virta program, and 87 adults opted for usual diabetes care. 

Of the original 262 participants following the Virta program, some of whom dropped out, an unprecedented 38% were able to sustain diabetes reversal at two years. Virta defines successful diabetes reversal as achieving an HbA1c under 6.5% with no medication besides metformin and remission as achieving this HbA1c level without any diabetes medication at all. 

Reduction in Insulin and Other Diabetes Medication

The Virta treatment group in the type 2 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, most participants achieved and maintained 5% weight loss by the end of the two-year study.

The type 2 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 (hs CRP 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 at two years (74%) than at one year (83%), there were no reported adverse events to the intervention that resulted in discontinuation for Virta patients, including no reported episodes of ketoacidosis or severe hypoglycemia requiring assistance. 

The Important Lessons Everyone Can Learn from Virta Health

Individuals with type 2 diabetes, prediabetes, metabolic syndrome, and related conditions can benefit from the insights and findings of Virta Health’s methods and research. 

Virta is demonstrating that their novel approach to diabetes prevention and reversal can significantly increase individual quality of life and lifespan and 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 ketogenic 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 the two-year study from Virta Health, the answer is yes, it is possible to reverse type 2 diabetes. 

What is the Virta program?

The Virta Health diabetes and prediabetes reversal program combines an individually tailored, ketogenic diet with a novel approach to patient education, support, and remote monitoring. Virta refers to their approach as continuous remote care with behavioral change.  

What does Virta health cost?

For patients paying out of pocket, Virta costs $299 per month, with a one-time $250 charge for their Starter Kit, which includes a blood glucose and ketone monitoring system. 

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. 

References

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