For many employers with an aging workforce, diabetes is often one of the top cost drivers for their health plans. Members with diabetes incur 2.3 times the healthcare costs of non-diabetics, and employees with diabetes reported missing work at a rate 46% higher than non-diabetic employees. Ideally, we would help employees and families prevent the development of diabetes, and there are many Diabetes Prevention Programs available today that are patterned after the model the Centers for Disease Control and Prevention (CDC) piloted and certified. But many who have already developed type 2 diabetes (T2D)—sometimes described as a lifestyle disease because being overweight, not getting enough exercise and not eating healthy foods are primary risk factors—are often faced with taking diabetes medications and insulin, monitoring their blood sugar, watching what they eat, and visiting their physician regularly to manage their condition for the rest of their lives.
In recent years, a number of vendors have developed diabetes support and monitoring services, some with WiFi-connected blood glucose monitors and health educators who coach when out-of-range glucose values are detected. Even more recently, Virta Health has entered the market offering what it claims is a “diabetes reversal” service. This service combines a low carbohydrate diet (ketogenic diet) with monitoring by health educators to assist with the prescribed dietary and lifestyle changes, and physicians to closely monitor and modify diabetes medications as metabolic changes occur.
Virta Health recently published results from the first year of a planned, multi-year clinical trial in which it compared the results of patients who followed the Virta Health program to patients who continued to receive “usual care” from their medical care providers. The 83% of participants who remained in the program after one year showed some promising results, including improved biomarkers, such as reduced HbA1c levels, the loss of 12% of their body weight, reduced diabetic medication use, and reduced or stopped insulin use (94% of those who used insulin at the beginning of the study).
It’s important to note that ketogenic diets have been used for many years to treat diabetes. The question has been, are people willing to sustain this type of diet to see continued improved metabolic function? While this study followed a relatively small number of patients in the Virta Health program (262), the fact that 83% of those were still participating after one year is encouraging. The study is continuing to follow participants through year two and beyond, so it will be interesting to see how many patients persist with the diet and lifestyle changes that are foundational to this approach. If the high-touch support provided by the Virta Health program proves to make a long-term difference, I believe many employers will take a closer look at this opportunity to support their members who have diabetes, and potentially reduce their health care spend on this costly and potentially devastating health condition.