Adams Rebecca N, Athinarayanan Shaminie J, Zoller Alison R, McKenzie Amy L, Ratner Robert E
Virta Health Corp, Denver, Colorado, USA.
Lingo Biowearables, Alameda, California, USA.
Diabetes Obes Metab. 2025 Sep;27(9):4825-4835. doi: 10.1111/dom.16525. Epub 2025 Jun 16.
To evaluate the long-term effectiveness and safety of a remote, medically supervised ketogenic nutrition therapy intervention for Veterans with type 2 diabetes (T2D).
This retrospective observational analysis examined de-identified medical records of Veterans with T2D who engaged in a remote continuous care intervention. Outcomes were HbA1c, weight, diabetes medication use and cardiometabolic markers (lipids, liver enzymes, kidney function) among those who remained enrolled for 2 or 3 years. Separately, we assessed weight, glucose and medication changes at programme departure among Veterans who discontinued before 2 years. Outcomes were analysed across subgroups. Linear mixed-effects models and paired t-tests evaluated changes over time.
Among 640 enrolled Veterans (mean age: 59 years, BMI: 35 kg/m, HbA1c: 8.4%), 310 (49%) remained engaged at 2 years and 197 (33%) at 3 years. At both time points, HbA1c was reduced by approximately 0.8%, alongside decreases in diabetes medication use. Weight decreased by approximately 9% at both 2 and 3 years. Overall, reductions in HbA1c and weight were seen across subgroups. Veterans who discontinued before 2 years experienced metabolic improvements, with greater benefits among those enrolled at least 6 months.
For US Veterans, long-term participation in a remote ketogenic nutrition therapy intervention was associated with sustained improvements in glycaemic control, weight, medication use and select cardiometabolic markers. A 0.8% HbA1c reduction is associated with meaningful reductions in diabetes-related complications, highlighting the potential clinical relevance of these findings.
评估针对2型糖尿病（T2D）退伍军人的远程、有医学监督的生酮营养治疗干预措施的长期有效性和安全性。
这项回顾性观察分析检查了参与远程持续护理干预的T2D退伍军人的去识别化医疗记录。对持续登记2年或3年的患者，观察指标包括糖化血红蛋白（HbA1c）、体重、糖尿病药物使用情况以及心脏代谢指标（血脂、肝酶、肾功能）。另外，我们评估了在2年之前退出项目的退伍军人在项目结束时的体重、血糖和药物使用变化情况。对各亚组的观察结果进行了分析。采用线性混合效应模型和配对t检验评估随时间的变化。
在640名登记的退伍军人中（平均年龄：59岁，体重指数：35kg/m，HbA1c：8.4%），310人（49%）持续参与了2年，197人（33%）持续参与了3年。在两个时间点，HbA1c均降低了约0.8%，同时糖尿病药物使用量也有所减少。在2年和3年时体重均下降了约9%。总体而言，各亚组的HbA1c和体重均有所降低。在2年之前退出的退伍军人代谢状况得到改善，至少登记6个月的退伍军人受益更大。
对于美国退伍军人而言，长期参与远程生酮营养治疗干预与血糖控制、体重、药物使用及某些心脏代谢指标的持续改善相关。HbA1c降低0.8%与糖尿病相关并发症的显著减少相关，突出了这些研究结果的潜在临床意义。
