Another question around reversal, especially for diet and lifestyle interventions, is sustainability. Is reversal realistic long-term?
In a traditional doctor-patient setting, where visits to medical providers happen a few times per year, sustained diabetes reversal may be difficult. Without proper support, lifestyle changes can be hard to start and maintain.
That’s where the telehealth revolution comes into play. For example, Virta provides “continuous remote care,” which gives patients around-the-clock support from health coaches and medical providers. This team also monitors biomarkers (things like weight and blood sugar) and makes recommendations for reducing medications in near real-time. This type of model, which is radically different from current models of infrequent or “episodic” care, makes reversal a real option. Technology enables the care delivery needed to not only reverse diabetes, but also sustain it.
When your blood sugar is no longer chronically elevated, these blood-sugar-lowering medications are no longer necessary. An ongoing study has shown that sustained nutritional ketosis can lead to the removal of these medications10. Medications that rapidly reduce blood sugar need to be removed first, such as insulin and sulfonylureas, sometimes in as little as 2 days to 2 weeks. Other medications like SGLT-2 inhibitors, DPP-4 inhibitors, GLP-1 receptor agonists, and metformin can be removed as long as you maintain normal blood sugar.
If you are on diabetes or blood pressure medications, Virta highly recommends that you get medical supervision before making any dietary changes.