Mobile app, ketogenic diet show promise in reversing Type 2 diabetes

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Remote monitoring via a mobile app and a diet very low in carbohydrates and high in fat has been shown to reverse Type 2 diabetes, according to one-year results from an ongoing five-year trial.

The study, funded by vendor Virta Health, assessed whether a remote care model with very low dietary carbohydrate intake and continuous supervision by a health coach and doctor via a mobile app could safely lower hemoglobin A1C, weight and reduce the need for medicines after one year in adults with Type 2 diabetes.

Of those receiving the intervention, 94 percent of patients on insulin decreased or eliminated their dosage by year’s end, while 60 percent of patients showed hemoglobin A1C levels below the diabetes threshold without medication or only metformin, which has indications outside of Type 2 diabetes. At the same time, a control group experienced no significant changes in A1C or diabetes medication use.

In addition, the study reported an average decrease of 1.3 percent in hemoglobin AIC and 12 percent weight loss for patients during the year.

“These results demonstrate that a novel metabolic and continuous remote care model can support adults with T2D to safely improve HbA1c, weight and other biomarkers while reducing diabetes medication use,” concludes the study, published last week in in Diabetes Therapy.

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According to Sarah Hallberg, the study’s principal investigator and medical director of Virta Health, the patients had a low carbohydrate nutrition plan that was personalized through their assigned health coaches, who communicated with them via the mobile app—sometimes multiple times per day. Patients were also given access to her—a physician—for the purposes of medication management, she notes.

“Due to the unique structure of the trial and use of telemedicine, we helped prevent any significant hypoglycemic events,” says Hallberg. “Instead of patients scheduling an office visit, they could log their blood sugar and ketone levels in the app. Then, both the patient and I could track their levels and make adjustments accordingly.”

Hallberg contends that biometric feedback was an important component of the intervention, enabling her as the study’s medical provider to make medication changes as indicated by participant-reported biomarkers.

“Each patient at the trial onset was given a cellphone-enabled scale,” she adds. “Each morning, they stepped on the scale, and it populated directly into the app. That (data) was able to be visualized by both the health coach and by me. And, also patients were inputting their blood sugar and ketone levels.”

Virta Health’s mission is to reverse Type 2 diabetes in 100 million people by 2025, according to Hallberg, who says the next step for research regarding the company’s treatment is obtaining two-year trial data and ultimately five-year outcomes. “It was initially set up to be only a two-year study, but we did extend the trial out to five years.”

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