Virta Study - T2D a thing of the past

(ianrobo) #1

Well @carl and @richard we have been waiting for this for a while and yes it is bias confirmation BUT the study shows what we knew

https://blog.virtahealth.com/with-sustained-type-2-diabetes-reversal-management-is-becoming-a-thing-of-the-past/

Remeber this is from their own patients, so somewhat self selecting but even the skeptical Kevin hall has been kind of positive

evin Hall @KevinH_PhD
5m
Impressive 1yr @virtahealth data treating T2D, including remote monitoring blood ketones to provide personalized diet adherence feedback to patients. But doesn’t “reversing” T2D require improved glucose tolerance, insulin secretion, & insulin sensitivity? More like T2D remission.

(Richard Morris) #2

Remission is a good thing.

The long path of being “not yet diabetic” is best described by decades of worsening insulin resistance, and glucose tolerance is just a late stage symptom. A decade of remissed T2DM will be a return journey along that path. At some point even Kevin Hall will have to admit he was wrong, and a ketogenic diet is appropriate for Diabetics.

(Janet) #3

Here are more details of results with the one year study.

https://blog.virtahealth.com/one-year-clinical-trial-outcomes-provide-evidence-for-changing-the-way-we-care-for-patients-with-type-2-diabetes/

Good chart of outcomes, post below.

The link to study. https://link.springer.com/article/10.1007%2Fs13300-018-0373-9

(Janet) #4

1-year-Outcomes-Table@2x-1300x1853.png1300×1853 123 KB

(ianrobo) #5

What we should remember Richard is this is self selecting and not a double blind test but highly motivated people. A few think this is a study, nope, it is effect a large N=1 experiment and that is far more valid !

(ianrobo) #6

should note that Jimmy Moore has Dr Sarah Hallberg on LLVLC just downloaded on this and will be listening tomorrow to what is said.

(ianrobo) #7

very good listen and of course this is not a double blinded random control study but actually @richard are these over rated ?? there was a control group of course but Sarah put the case very well and the study will be going 5 years and the second year is due to finish shortly.

(Richard Morris) #8

No I think they should be the gold standard. But the controlled study that Virta are doing is the first time we’ve had that for ketogenic diets over a decent duration.

(ianrobo) #9

and as Sarah said the important thing was they were controlled diets by regular ketone measurements Richard, and not food diaries alone. So obviously if they went out of Ketosis they could see what caused it. Plus it was the modern medicine, do the measurements into an app and the doctor at Virta would respond within hours if any problems are seen …

That is a fully controlled test with proper food data

(Lyn Storey) #10

Have they said what time of day they had participants check their ketones?

(Melanie Armistead) #11

I just got blocked for quoting the VIRTA results on a facebook post calling for ketone strip sales to be limited to type 1 diabetics (note, I didn’t say or imply that T1D shouldn’t have priority access to the strips, just explained why those of us with T2D/pre-diabetic etc use them).

Capture

Have a read of the whole conversation if you’re after some entertainment (it’s a public post/profile) - hell, tell me if I got anything wrong (I may have neglected to specify that the diabetic patients were only type 2, not type 1, but the article title makes that pretty clear).

But above all, feel free to let people know that the ‘dangerous article’ that I posted is actually a journal article in a peer-reviewed Diabetes journal.

@richard: does this make me a sardine or a troll? :joy:

(Melanie Armistead) #12

PMSL - she took down the post that referred to the study (it was dangerous after all). I guess she didn’t want people to look for themselves or to consider another view…

Melanie Armistead That wasn’t from an article, it’s a culmination of what I’ve read, learned from others (including doctors) and experienced myself over the last year and a half.

You can pick holes in any study if you look hard enough, but when it comes to your health, the most relevant study is n=1 (what works for you).

Personally, 18 months ago I had chronic psoriatic arthritis, exercise induced asthma, fatty liver, CRP in the 20s (on humira and methotrexate), pre-diabetic blood markers and was 115kg. I’d been sick and tired for most of my life and following the nutrition guidelines wasn’t working for me. Now I’m around 85kg, CRP4, no sign of fatty liver or diabetes and both the arthritis and asthma are in remission - but when I revert to a ‘normal’ diet, the pain, inflammation and wheezing come back.

Speaking of studies, have you seen the Virta Health study (published last month) where they kept 262 diabetics and pre-diabetics/metabolic disease in ketosis for a year? 94% reduced/removed insulin, 60% reversed all blood markers of diabetes. HbA1c, triglycerides and inflammation all decreased, average weight down 30 pounds (around 13.6kg). They adapted the ‘diet’ to each individual by monitoring blood glucose and ketones daily.

The control group of 87 people received normal diabetic care: after one year were they on more medication, had higher HbA1c, triglycerides and inflammation and no change in weight.

It wasn’t randomised or double blind (the participants were given the choice to follow the normal guidelines or participate in the intervention), but having the choice has resulted in a higher retention rate, because no-one was forced into following a diet that they don’t want to. And they didn’t provide any food, just the guidelines, so the participants had to work out how to fit keto into their own lives and budgets.

I’m not trying to claim that T1D shouldn’t have first priority for ketone sticks, I’m just pointing out that those of us with insulin resistance and chronic conditions have a valid reason for using them too - and if more of us took the initiative to improve our own health, it’d free up a lot of the money that is currently spent managing our conditions so it could be put to better use.

Tamara Currie Now your talking rubbish !
Out of 262 " diabetics " and " pre - Diabetics " you say - 94% of them

Tamara Currie I am very close to blocking you Melanie

(Rob) #13

Your post was (obviously) totally reasonable.

As discussed before, many T1 and long-term T2 have a massive martyr complex on one side due to their perception of their disease as a god-given cross to bear that they can’t change (thanks docs!). On the other side, some folks (T1/2 independent) are dicks with a god complex who get enjoyment through their control of others (amplified for T1s by the lack of perceived control over themselves). You’ve just met the perfect storm in Tamara. :scream:

I would use back channels to tell people you like there to just get the hell out and research in the wider world and leave the Cult of Tammy! :exploding_head:

#14

Melanie, this is so frustrating! Frustrating in a small way because you were making clear logical statements and were blocked for no reason.
Frustrating in a big way because your success story and message will reach fewer people (and also - ugh… to watch how dogma just begets more dogma, which begets more T2D :tired_face:)

But this :

is so amazing! I would just enjoy your amazing success and put your helping energy where it is welcome.

(Richard Morris) #15

Sardine’s are awesome :slight_smile:

One truth for type 1 diabetics is that they could die in their sleep any moment if they slip up slightly with their diet/exercise/dosing and become hypoglycemic. There is not much hope on the horizon for them to ever be able to reverse their disease, and everyone keeps confounding THEIR disease with that of type 2 diabetics who can now apparently reverse their disease.

The reality for type 2 diabetics is that we are often told from day one, “Well you did that to yourself. It’s a lifestyle disease, and you made bad choices”. In a strange kind of way, that deep shame that we likely feel over that is liberating as it allows us to move past the first 4 Kübler-Ross stages (Denial, Anger, Bargaining, Depression) and get straight to Acceptance. “Heck I did it to myself, after all”.

The ketogenic diet can be a treatment for both types of diabetes. It can’t cure type 1 diabetes, but it can reduce the glucose excursions, and most importantly the chances of hypoglycemia. It doesn’t always cure type 2 diabetes either. But it is important to let all diabetics know about it as an option. While the Virta study is a great sign post for type 2 diabetics, we need more fundamental research on type 1 diabetics. I understand several of those are underway and hopefully we should see them published soon.

(Adam Kirby) #16

Prediction: in 5 years time all the major health and diabetes organizations will say that LCHF is perfectly fine and pretend they never opposed it. They may not be recommending it yet as the primary intervention for obesity and T2D but they’ll be saying, sure, if you want to eat keto go right ahead.

(Bunny) #17

Nice!

Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study Conclusions: These results demonstrate that a novel metabolic and continuous remote care model[1] can support adults with T2D to safely improve HbA1c, weight, and other biomarkers while reducing diabetes medication use.

Plain Language Summary:

Treatments for type 2 diabetes (T2D) have improved, yet T2D and being overweight are still significant public health concerns. Blood sugar in patients with T2D can improve quickly when patients eat significantly fewer dietary carbohydrates. However, this demands careful medicine management by doctors, and patients need support and frequent contact with health providers to sustain this way of living[1]. The purpose of this study was to evaluate if a new care model with very low dietary carbohydrate intake and continuous supervision by a health coach and doctor could safely lower HbA1c, weight and need for medicines after 1 year in adults with T2D. 262 adults with T2D volunteered to participate in this continuous care intervention (CCI) along with 87 adults with T2D receiving usual care (UC) from their doctors and diabetes education program. After 1 year, patients in the CCI, on average, lowered HbA1c from 7.6 to 6.3%, lost 12% of their body weight, and reduced diabetes medicine use. 94% of patients who were prescribed insulin reduced or stopped their insulin use, and sulfonylureas were eliminated in all patients. Participants in the UC group had no changes to HbA1c, weight or diabetes medicine use over the year. These changes in CCI participants happened safely while dyslipidemia and markers of inflammation and liver function improved. This suggests the novel care model studied here using dietary carbohydrate restriction and continuous remote care can safely support adults with T2D to lower HbA1c, weight, and medicine use. …More

[1]Footnote: REMOTE PATIENT MONITORING PLATFORMS