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. 2021 Dec;23(12):2643-2650.
doi: 10.1111/dom.14515. Epub 2021 Aug 19.

Effectiveness of a ketogenic diet and virtual coaching intervention for patients with diabetes: A difference-in-differences analysis

Kiersten L Strombotne  1   2 , Jessica Lum  2 , Nambi J Ndugga  1   2 , Anne E Utech  3 , Steven D Pizer  1   2 , Austin B Frakt  1   2   4 , Paul R Conlin  2   5
Affiliations

Effectiveness of a ketogenic diet and virtual coaching intervention for patients with diabetes: A difference-in-differences analysis

Kiersten L Strombotne et al. Diabetes Obes Metab. 2021 Dec.

Abstract

Aim: To test the effectiveness of a ketogenic diet and virtual coaching intervention in controlling markers of diabetes care and healthcare utilization.

Materials and methods: Using a difference-in-differences analysis with a waiting list control group-a quasi-experimental methodology-we estimated the 5-month change in HbA1c, body mass index, blood pressure, prescription medication use and costs, as well as healthcare utilization. The analysis included 590 patients with diabetes who were also overweight or obese, and who regularly utilize the Veterans Health Administration (VA) for healthcare. We used data from VA electronic health records from 2018 to 2020.

Results: The ketogenic diet and virtual coaching intervention was associated with significant reductions in HbA1c (-0.69 [95% CI -1.02, -0.36]), diabetes medication fills (-0.38, [-0.49, -0.26]), body mass index (-1.07, [-1.95, -0.19]), diastolic blood pressure levels (-1.43, [-2.72, -0.14]), outpatient visits (-0.36, [-0.70, -0.02]) and prescription drug costs (-34.54 [-48.56, -20.53]). We found no significant change in emergency department visits (-0.02 [-0.05, 0.01]) or inpatient admissions (-0.01 [-0.02, 0.01]).

Conclusions: This real-world assessment of a virtual coaching and diet programme shows that such an intervention offers short-term benefits on markers of diabetes care and healthcare utilization in patients with diabetes.

Keywords: dietary intervention; health economics; type 2 diabetes; weight control.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors have no potential conflicts of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Flow diagram of veterans in the analytical sample. VHA, Veterans Health Administration
FIGURE 2
FIGURE 2
Difference-in-differences graphs for 5-month changes in diabetes outcomes for veterans in the ketogenic diet and virtual coaching treatment and control groups, before and after Virta application dates. Shown are the average monthly trends in eight different outcome measures (HbA1c, body mass index [BMI], systolic blood pressure [SBP], diastolic blood pressure [DBP], number of diabetes medication fills [No. T2D Rx], number of insulin medication fills [No. insulin Rx], number of Veterans Health Administration [VA] outpatient visits and number of VA emergency department [ED] visits) for the Virta treatment group and the waiting list control group. Virta application month is indexed at month zero
See this image and copyright information in PMC

References

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