Diabetes Reversal Program Boasts Strong One-Year Outcomes: 1.4% A1C Drop, 11% Weight Loss

By: Robert Groves, MD

Robert Groves, MD, has been innovating health care for 40+ years across diverse roles, from private practice to delivery and payer systems. As executive vice president and chief medical officer at Banner|Aetna, he is known for implementing transformative health care technology and programs that simplify care, reduce costs, and boost accessibility. He is widely regarded as an industry thought leader and is regularly invited to speak on health care topics, including metabolic health and telehealth solutions.

Before the discovery of insulin in 1921, diabetes was a seriously life-limiting condition. Doctors had no effective way to treat the disease and once diagnosed, patients lived an average of only four years. Since then, the therapeutic use of insulin has meant the difference between life and death for tens of millions of people. However, insulin is only part of the equation when it comes to managing diabetes. For many people, diabetes reversal is possible through healthy lifestyle changes.

What is diabetes?

Diabetes is a chronic disease that disrupts how the body metabolizes sugar. Normally, as sugar levels in the blood rise, the pancreas releases insulin.

With Type 1 diabetes, the pancreas produces little or no insulin due to genetic or environmental factors that are not well understood by experts. With Type 2 diabetes, the pancreas may produce insulin, but the body can’t use it effectively because of a combination of genetic factors and lifestyle influences such as obesity or smoking.

When either type of diabetes is left untreated, rising glucose levels in the body lead to dangerous problems with the circulatory, nervous and immune systems.

A notable distinction between Type 1 and Type 2 diabetes is reversibility. Type 1 diabetes requires lifelong insulin treatment.

Type 2 diabetes is different. First, it accounts for 90-95% of all diabetes cases and often starts with prediabetes, where blood glucose levels are higher than normal but not yet high enough to be diagnosed with the disease. In nine out of 10 people, Type 2 diabetes is preventable with lifestyle modification. For those who already have Type 2 diabetes, studies show diet and lifestyle interventions are still incredibly effective and can even lead to diabetes reversal.

A snapshot of diabetes in the US

Despite the development of lifesaving medications and treatments like insulin, diabetes is the eighth leading cause of death in the U.S. and claims more than 100,000 lives each year. In terms of economic impact, a quarter of all health care spending in the U.S., or $412.9 billion each year, is spent on diabetes care. That’s one out of every four health care dollars.

And rates of the disease continue to climb, driven almost entirely by Type 2 diabetes. What’s even more concerning is the dramatic uptick in Type 2 diabetes among younger people (under 40 years), adolescents and even children over the last few decades.

Prediabetes, a precursor to the disease that can be reversed with lifestyle changes, now affects one in three people. But because most people who have it don’t realize it, they are unlikely to make the modifications necessary to delay or prevent the onset of the full-blown disease. Unless something radically shifts, studies estimate that the number of people living with diabetes will more than double by 2050.

These are alarming trends, but there is hope. After a routine visit with my own primary care provider a few years ago, I learned I was prediabetic. As a physician who has spent years focused on treating and preventing metabolic diseases including diabetes, I was surprised. But I also understood that prediabetes did not mean I was destined for a life of finger pricks and insulin injections. So, I decided to practice what I preach and take a holistic approach to reversing my high blood sugar. I started my journey as part of Banner|Aetna’s diabetes reversal pilot program, powered by Virta Health.

How Type 2 diabetes reversal is changing the game

Instead of accepting the progression of Type 2 diabetes as inevitable, Banner|Aetna’s diabetes reversal program helps people make lifestyle changes that address the root cause of the disease. This is in line with the latest American Diabetes Association guidance.

The evidence-based program is designed to induce nutritional ketosis via tailored nutrition therapy. Nutrition ketosis is a natural metabolic state that happens when carbohydrate consumption drops low enough that the body uses fats

and ketones instead of carbohydrates for energy. As a result, participants lose weight, see better lab values, and need fewer diabetes medications overall. Most no longer require insulin and some even see their diabetes reversed completely.

The program’s personalized support and continuous remote monitoring from a team of licensed providers (doctor, health coach, dietician, etc.) help make these changes sustainable. A recent assessment found that only programs centered on nutritional ketosis have achieved clinically significant results.

Personally, the program has helped me get my sugar levels back to normal and I no longer have prediabetes. Overall, Banner|Aetna members have also achieved remarkable results. According to our clinical data, improvements in the first year show:

• Prescription medication reduction: Members eliminated 66% of diabetes medications (excluding metformin), including an 83% reduction in insulin dosages. Of those on insulin, 58% eliminated it completely.
• Blood sugar reduction: Members saw an average 1.4% reduction in A1C blood sugar levels. (Every one-point decrease in A1C reduces the risk of long-term diabetes complications by up to 40%.)
• Clinically significant weight loss: On average, members experienced 11% weight loss (5% is considered clinically significant). Clinically significant weight loss can lead to better sleep, reduced inflammation, improved blood pressure, reduced risk of heart disease and positive impacts on arthritis and fatty liver disease.

The future of diabetes care

The growing prevalence of Type 2 diabetes has devastating health consequences and puts more pressure on an already overburdened health care system. Though medical and pharmacological breakthroughs, like insulin, have helped many people with diabetes live longer, they do little to address the underlying cause of the disease. The silver lining is that holistic programs like Banner|Aetna’s can help people successfully address the root issues that cause Type 2 diabetes and achieve diabetes reversal.

To further support members, Banner|Aetna recently launched “The Eco” (short for the Banner|Aetna Ecosystem). The comprehensive suite of complementary programs is intended to help members achieve lasting metabolic transformation by completely reimagining care management. The integrated “hub and spoke” model seamlessly supports weight loss, nutrition, physical activity and behavioral changes—all of the things that make a difference when striving for holistic health improvement.

Banner|Aetna’s Type 2 diabetes reversal is available at no extra cost to eligible members fully insured and Administrative Services Only groups. Self-funded employer groups can also access prediabetes reversal offerings that use the same innovative care model to deliver sustainable health transformation.

If you’re interested in learning more about our coverage, visit our Employer or Individual pages.