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 34 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.

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:

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 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.

References

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