Solving the type 2 diabetes epidemic

When we first met Mark, he was taking six diabetes medications a day, including insulin, yet he still had elevated blood glucose with an HbA1c of 8.3%, well above the diabetic threshold of 6.5%. Robin was out of work on disability, suffering from loss of vision, and was black and blue from her multiple insulin injections every day. And Wilma, with her high blood pressure and daily insulin, lacked the energy to be the fun, active grandmother she had always wanted to be.

Each story is unique and heartbreaking in its own way. Yet they are representative of a larger trend in the US, as 29 million Americans are now living with type 2 diabetes, and 86 million more have prediabetes.1 We already spend more than $300 billion per year on diabetes and prediabetes combined in the United States.2 This isn’t just a problem in the U.S., as globally nearly 400 million people suffer from type 2 diabetes.3

Clearly our current approach isn’t solving the epidemic. We founded Virta to change this. We want to help the millions of individuals living with type 2 diabetes reverse their disease instead of just manage it, all while saving the health care system billions of dollars.

How Virta was formed

Like most people, I had always believed that type 2 diabetes was a matter of non-compliance. My logic followed the conventional wisdom. Since obesity is a major driver of type 2 diabetes, both must result from people’s inability, or unwillingness, to do the obvious: eat less and exercise more to avoid gaining extra pounds in the first place. This all changed for me the year I won the triathlon world championships in my age group and found out that I was pre-diabetic and metabolically unhealthy. How could this happen to someone like me, a high performing endurance athlete and stubborn engineer, who followed the “best” advice and was not overweight?

This started my personal journey of discovery and reading the latest peer-reviewed science, which led me to my co-founders Dr. Stephen Phinney and Dr. Jeff Volek. Together Steve and Jeff had a combined 70 years of research on metabolic health and insulin resistance. They had literally just written the protocol on safe and evidence-based type 2 diabetes treatment that had the potential to actually reverse the disease without surgery. It was clear from Steve and Jeff’s work that my assumptions were wrong: our diabetes epidemic is not just a matter of non-compliance, and even advanced type 2 diabetes could be reversed.

But to reverse diabetes sustainably and cost-efficiently in millions of people, we needed to change the care delivery model from a periodic physician visit to continuous and highly personalized remote care in an outpatient setting. I knew this could be done by empowering a physician-led care team with technology and artificial intelligence. And so, we formed Virta in 2014, with a mission to reverse diabetes in 100 million people by 2025. I’m excited that we can finally share more about our results and plans.

Virta outcomes and clinical evidence

Virta is an online specialty medical clinic that reverses type 2 diabetes safely and sustainably, without medications or surgery. To date, the only clinically proven way to reverse diabetes has been bariatric surgery. Although bariatric surgery has been shown to deliver 30-65% diabetes remission rates, it is drastic and irreversible, comes with high costs and serious risks, and isn’t covered for many patients.4 Meanwhile, managing type 2 diabetes with costly medications and lifestyle interventions is at best about slowing down the progression of the debilitating disease and rarely, if ever, results in diabetes remission.5

This is now changing. Our first published and peer-reviewed results from our clinical trial, in partnership with Indiana University Health, showed that in the majority of our diabetic patients, we can safely reverse type 2 diabetes, eliminate diabetes medications, bring blood sugars down to non-diabetic levels, and have more than 90 percent of our patients follow and complete the Virta Clinic protocol. We couldn’t be happier for Virta patients like Mark, Robin, and Wilma, who have experienced these successes after many years of living with type 2 diabetes, and in some cases, injecting hundreds of units of insulin daily. These are a few of the many examples of how people are changing their lives with Virta. But this is just the start and we can’t wait to share our one and two year results very soon. As a science- and evidence-based company, we will continue to push for transparency by publishing our scientific and clinical results.

How we reverse type 2 diabetes

Type 2 diabetes is typically described as a chronic disease that is progressive and incurable. We are changing this by driving two major innovations based on decades of research in metabolic health and nutritional biochemistry, including that of our founders and advisors:

  1. A highly individualized approach to nutritional biochemistry: With particular focus on carbohydrate intake and nutritional ketosis, Virta addresses the underlying causes of insulin resistance and shifts the paradigm from managing diabetes to safely and sustainably reversing it.
  2. Technology that enables continuous, remote care and personalization at scale: The Virta Clinic reinvents typical, periodic outpatient care by offering continuous, remote care enabled by our technology. We use data science and machine learning to help Virta physicians and dedicated Virta health coaches personalize each patient’s care plan and offer real-time support and guidance.

Taken together, these two innovations enable us to deliver truly personalized care with high engagement in an outpatient setting, which is essential for sustainable reversal of type 2 diabetes in millions of people, each with unique biochemistry, medications, and life circumstances.

A referral partner for PCP’s and specialists

Although Virta is a provider, we don’t take the role of anyone’s primary care physician. Our goal is to be a valuable referral partner for physicians who are seeking more effective approaches for people with type 2 diabetes. As a specialty provider, we partner with primary care physicians and other specialists, so that physicians like Dr. Bilbao and Dr. Savant can focus on what they do best, while we help their patients reverse diabetes safely and sustainably. Patients can enroll directly into the Virta Clinic or be referred by their provider.

Working with organizations to lower health care costs

For employers, insurance carriers and government entities, diabetes as a chronic disease is a substantial driver of health care costs and reduced economic output and productivity. By reversing type 2 diabetes quickly, we can deliver substantial cost savings. Furthermore, we’ve aligned the interest of the patient, the payer of the health care services and Virta, by offering the Virta Clinic on pay-for-success-only basis. In other words, we only get paid for results, which is how everybody should be incentivized.

Our team

None of this would be possible without our talented team. We are also proud to count as our advisors Children’s Hospital Oakland Research Institute’s Dr. Ronald Krauss, Harvard Medical School’s Dr. Bruce Bistrian, UCSF’s Dr. Frederick Hecht, endocrinologist Dr. Carol Levy of Mount Sinai Hospital, Senator Bob Kerrey, Dr. Peter Attia, Dr. Zeev E. Neuwirth, and former Chief Medical Officer of the American Diabetes Association Dr. Robert Ratner, among others. Our financial supporters have also lent tremendous wisdom and passion for our cause, including Venrock, Allen & Company, Ev William’s Obvious Ventures, Redmile Group, Max Levchin’s Scifi VC, Dr. Elad Gil, several physician angel investors and many others.

Patients first

Virta will always be about our patients and their well-being, which is why I’m so thrilled for Mark, Robin, and Wilma, whom I introduced earlier. Mark has lost more than 80 lbs, eliminated 5 medications including insulin, and has an A1c of 5.6, within the normal range. Robin eliminated all of her insulin, significantly improved her eyesight, and is now thinking about going back to work. And Wilma now has an A1c below the type 2 diabetes diagnostic threshold, has discontinued insulin and lost 20% of her body weight. Even better, she has the energy to be the active grandmother she’d always wanted to be. These results are not supposed to be possible without surgery. Yet, we have now shown that we can reverse diabetes in the majority of our patients.

We have a lot of work ahead of us to help millions of people living with type 2 diabetes, and we’d love for you to join us on this journey, too.

Sami and the entire Virta team

Citations
1. https://www.cdc.gov/diabetes/data/statistics/2014StatisticsReport.html
2. http://www.diabetes.org/diabetes-basics/statistics/infographics/adv-staggering-cost-of-diabetes.html
3. http://www.idf.org/diabetesatlas/
4. https://www.ncbi.nlm.nih.gov/pubmed/24374842
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237974/