A keto diet successfully treats prediabetes in over 50% of patients

A recent study from Dr. Sarah Hallberg and colleagues at Virta Health, a company that provides treatment for the reversal of type 2 diabetes, reports that their program promoting carbohydrate reduction normalizes blood sugar in over 50% of people with prediabetes.

In 2019, we promoted the impressive results from studies by Dr. Sarah Hallberg and her team at Virta, demonstrating the effectiveness of their ketogenic diet intervention for treating type 2 diabetes. Now, they have similar findings for those with prediabetes.

Their most recent intervention utilized an app-based coaching program, promoting a diet with fewer than 30 grams of total carbs, at least 1.5 grams per kilo of protein, and consumption of dietary fat to satiety.

At two years, the authors note 75% retention, which is excellent when it comes to a nutritional intervention. They compare their findings to the much lower retention displayed in the National Diabetes Prevention Program.

The authors also report that 52.3% of participants achieved a normal blood sugar level at two years. On average, participants lost 12 kilos (11% of their initial body weight) and saw significant improvements in their high-density lipoprotein (HDL), triglycerides, liver function, and fasting insulin levels.

Since this is not a randomized study, there is no control group for comparison. Therefore, we cannot claim that a ketogenic diet is more effective than other diets for prediabetes.

However, we can conclude that a low-carbohydrate diet — with adequate protein — is an effective option for impressive weight loss and prediabetes treatment.

We can also conclude that those who follow the prescribed diet and participate in their care model have excellent compliance at two years.

The timing of these results juxtaposes nicely with the recent results published in The New England Journal of Medicine (NEJM) and The Journal of the American Medical Association (JAMA), showing an impressive 15% average weight loss benefit from semaglutide, a GLP-1 agonist medication.

These studies also reported a 0.5% decrease in A1c (a marker reflecting average blood glucose levels for the past three months) and improved triglycerides and serum insulin.

Together, the Virta health trial and the semaglutide trials demonstrate the importance of weight loss for improving metabolic health. However, semaglutide comes with side effects in 80% of people in the studies.

Fortunately, side effects were not severe in most people. But the high rate of participants who experienced them leads us to question whether individuals may be “better off” taking medication or trying a low-carb intervention program, such as the one used by Virta.

At Diet Doctor, we believe everyone deserves the support and encouragement to succeed with natural healthy weight loss. If extra support is needed, weight loss medications and even surgery are viable options.

As we have seen repeatedly, prioritizing protein and reducing carbohydrates can help many people succeed without medication or surgery.

Thanks for reading,
Bret Scher MD FACC

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