Contrary to claims, Virta has not reversed diabetes.

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Contrary to claims, Virta has not “reversed diabetes”.

Not tolerating carbohydrate is a pathology. If diabetes has been reversed, glucose tolerance should be restored. If glucose tolerance has not been restored, then LCHF is no different paradigmatically than symptom management with pharmacotherapy.

That disease reversal requires a test with carbohydrate does not imply that a high carbohydrate diet should be resumed for more than a few days, if a low-carbohydrate diet is the preferred means to achieve disease reversal.

That disease reversal requires a test with carbohydrate only implies that a brief demonstration of carbohydrate tolerance is necessary to demonstrate disease reversal.

A few days of carbohydrate at reasonable calorie intake will not compromise glucose tolerance if disease reversal has been achieved. If it does, then disease reversal has probably not been achieved.

Since Virta has not verified disease reversal in the manner explained above, it cannot be said that the Virta study has achieved reversal of diabetes. This is well-understood by the Virta scientists, and it is still unknown why their study has not incorporated this evaluation.

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2 Comments

  1. TBF the paper never once claims “reversal” of diabetes, only improved management with reduced medication use. If still call that a win.

    1. Echanda – Virta does claim reversal: “There was also resolution of diabetes (reversal, 53.5%; remission, 17.6%) in the CCI group but not in UC. ” (Doi:doi: 10.3389/fendo.2019.00348).
      Reversal is used very broadly in that case and is defined as: “Sub-diabetic hyperglycemia and normoglycemia (HbA1c below 6.5%), without medications except metformin” with remission being “Normoglycemia of at least 1 year duration, HbA1c below 5.7%, without any medications (two HbA1c measurements)”
      There is still no evidence that carbohydrates can be tolerated – which may mean a lifelong commitment to a LC diet with increasing LDL (up 10% in 2 years vs c 10% reduction in the usual care group) with uncertain outcomes

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