Inkisen Samin Virran vaikutus oli ratkaiseva siinä, että Yhdysvaltain diabetesliitto ADA joutui ottamaan hyväksyvän kannan ketoruokavalioon diabeetikon ruokavaliona. Lääkäreiden ammattilehti ACP Internist kirjoittaa:Diabetes remission through diet may be doable, with support
One fee-based specialty clinic, Virta Health, uses an individualized ketogenic diet, a very low-carb dietary approach (typically <30 g of total carbs per day) used to achieve nutritional ketosis, while providing continuous remote monitoring. Through telemedicine, health coaches provide ongoing support, and physicians keep an eye on medications, symptoms, comorbidities, and patients' daily measurements of blood ketones and fasting and postprandial blood glucose levels.
Most of Virta's patients have employer-sponsored health plans through self-insured employers, such as Purdue University, which offer the service as a fully covered benefit for type 2 diabetes, said ACP Member Jeff Stanley, MD, a Virta physician in Portland, Ore. On the other hand, patients who pay out of pocket incur a monthly fee of $370, plus a $500 starter-kit fee, according to the company's website, which also notes that its costs are not covered by most insurance plans.
In a recent study, Virta researchers compared changes at one year in HbA1c, weight, and diabetes medication use (other than metformin) in 262 adult patients using their model to 87 patients receiving usual care from their doctors and a diabetes education program. On average, those in the intervention group saw their HbA1c levels drop from 7.6% to 6.3% while losing 12% of their body weight and reducing the use of diabetes medications. In contrast, patients in the usual care group had no significant changes in HbA1c, weight, or diabetes medication use, according to results published in February 2018 by Diabetes Therapy.
Dr. Stanley, who has practiced telemedicine for the past two years with Virta, said his No. 1 job is to safely deprescribe medications as patients make dramatic changes to their diets. The need to do so rapidly arises. “There's this common misconception that in order to reverse diabetes or get off the medications, you need to have this large, dramatic weight loss,” he said.
One criticism of the Virta study is that it wasn't a randomized trial. Positive results from two small randomized trials of the ketogenic diet, however, prompted the ADA to add language to its 2018 guidelines noting that clinicians can consider the ketogenic diet as a short-term strategy (up to three or four months) for diabetes if a patient wants to try it.
Ennen Virtaa sanottiin, että ketoruokavalio tappaa. Nyt sanotaan, että se ei ole ainoa hyvä vaihtoehto. Ja varmuuden vuoksi vain 3-4 kuukaudeksi. Mutta on tämä jonkinlainen alku.