Type 2 Diabetes (T2D) affects one in four Veterans and often occurs with dyslipidemia, chronic kidney disease, and nonalcoholic fatty liver disease (NAFLD) . In a pilot program, the Veterans Health Administration partnered with Virta Health to provide carbohydrate restricted nutrition therapy via continuous remote care to Veterans to reverse T2D by reducing glucose and dependence on medication, as demonstrated in prior research. This retrospective analysis assessed the 1- and 2-year effects on lipids and renal and hepatic markers in a real-world sample of Veterans with T2D using medical record data. Changes in metabolic markers from enrollment to 1- and 2-years (E, 1y, 2y) were assessed with paired t-tests with Holm-Bonferroni correction for multiple comparisons. Veterans retained at least two years at time of analysis were included (n=254, 58.5% of 434 eligible enrolled, 60±8 years, 12% female) . HDL-C (E: 42±16, 1y: 46±12, 2y: 44±11 mg/dl; ps<0.001) and triglycerides (E: 205±168, 1y: 186±184, 2y: 160±119 mg/dl; 2y p<0.05) improved. Total cholesterol (E: 165±46 mg/dl) and nonHDL-C (E: 124±46 mg/dl) were unchanged. Serum creatinine (E: 1.0±0.3 mg/dl) and eGFR (E: 85±18 ml/min/1.73m2) were stable; BUN increased (E: 17.3±6.1; 1y: 19.6±8.4, 2y: 18.9±7.6 mg/dl, ps<0.05) but remained within normal limits. Liver enzymes (ALP at E: 77.8±24.6 U/L; ALT at E: 32.3±17.1 U/L) were within normal limits and unchanged except AST decreased (E: 26.6±14.1, 1y: 21.7±8.7, 2y: 21.8±9.3 U/L, 2y p<0.05) . Veterans with T2D who underwent two years of diabetes reversal treatment improved atherogenic dyslipidemia and AST with no adverse effects on other markers of NAFLD and renal function, suggesting long term broad metabolic health benefit of this care model in the real world.
M.Vantieghem: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. A.L.Mckenzie: Employee; Virta Health Corp., Stock/Shareholder; Virta Health Corp. R.E.Ratner: Employee; Virta Health Corp.