Virta Health is a telehealth company that treats type 2 diabetes and prediabetes through a medically supervised low-carbohydrate diet designed to put the body into a state called nutritional ketosis. The goal is not just to manage blood sugar but to reverse the disease, defined as bringing HbA1c below 6.5% without diabetes medications (or with only metformin). In a two-year clinical trial, 54% of participants in Virta’s program achieved that reversal benchmark, compared to just 9% in the control group.
How the Program Works
Virta’s core approach is carbohydrate restriction strict enough to shift the body’s primary fuel source from glucose to fat. When carbohydrate intake drops low enough, the liver produces molecules called ketones, which cells can burn for energy instead of sugar. This metabolic state, nutritional ketosis, reduces blood sugar levels and decreases the body’s need for insulin. For people with type 2 diabetes, that can mean fewer medications and, in some cases, none at all.
Everything happens remotely. When you enroll, Virta sends a digital scale, a glucose meter, and a ketone meter. You use the Virta app to log readings and track your food. A health coach is available through the app’s messaging system as often as you need, and you can schedule video calls with both your coach and a medical provider. The medical team adjusts your diabetes medications in real time as your blood sugar improves, which is a critical safety feature since lowering carbs while staying on insulin or other glucose-lowering drugs can cause dangerous drops in blood sugar.
Clinical Trial Results
Virta’s published research provides some of the strongest evidence for any telehealth diabetes program. In the company’s landmark trial, participants were followed for two years and then offered a three-year extension. At the two-year mark, 54% of the intervention group had reversed their type 2 diabetes. By comparison, the reversal rate in the control group actually dropped from 16% to 9% over that same period.
The five-year data, published in 2024, tells a more nuanced story. Of the original 262 participants, 122 remained in the study at five years. Among those completers, 32.5% still met the reversal threshold of HbA1c below 6.5% without medication or with only metformin. A stricter measure of remission, which requires sustaining that threshold over consecutive years, held for about 12.5% to 20% of completers depending on the timeframe used.
Beyond blood sugar, the five-year results showed lasting improvements in several metabolic markers. Body weight dropped an average of 7.6%. Triglycerides fell by 18.4%, and HDL cholesterol (the protective kind) rose by 17.4%. Inflammatory markers also improved. LDL cholesterol and total cholesterol did not change significantly in either direction, a finding that has been a point of debate since very low-carb diets are sometimes associated with rising LDL in certain individuals.
Medication Reduction
One of Virta’s most concrete selling points is how many medications participants are able to stop taking. According to the company’s own data, members eliminate an average of 44% of their diabetes prescriptions within one year. For members aged 65 and older, that figure rises to 49%. Across its entire membership, Virta reports eliminating 75 million units of insulin, translating to roughly $20 million in insulin cost savings alone.
This medication reduction doesn’t happen on your own. Virta’s physicians oversee every dosage change, tapering medications as blood sugar levels allow. This is one of the key differences between Virta and simply following a keto diet from a book or website. Adjusting insulin or other diabetes drugs without medical oversight can be dangerous.
Who Can and Can’t Use Virta
Virta is designed for adults between 18 and 80 with type 2 diabetes or prediabetes. Several conditions disqualify you from enrolling:
- Advanced kidney disease: stage 4 or 5 chronic kidney disease, or end-stage renal disease requiring dialysis
- Pregnancy or nursing
- Recent diabetic ketoacidosis (a dangerous complication) within the past 12 months
These exclusions exist because nutritional ketosis changes how the body processes fluids, electrolytes, and medications. Kidneys that are already severely compromised may not handle those shifts safely, and the metabolic demands of pregnancy require a different nutritional approach.
Cost and Insurance Coverage
Most people access Virta through an employer or health plan that covers the program as a benefit. Employers including AutoZone, US Foods, and Nielsen have partnered with Virta, and health plans like Humana and Banner|Aetna offer it to their members. If your employer or insurer covers Virta, enrollment is typically free or low-cost to you.
If you don’t have coverage, individual enrollment costs $299 per month plus a one-time $250 initiation fee. That price includes the connected devices, app access, health coaching, and physician oversight. For context, the average American with type 2 diabetes spends roughly $9,600 per year on direct medical costs related to the disease, so for some people the math works out favorably, especially if medication costs drop significantly. Still, $300 a month is a meaningful expense, and there’s no guarantee of reversal.
What the Five-Year Data Really Shows
The clinical results are promising, but they come with important caveats. The biggest one is retention. Of the 262 people who started the intervention, only 122 completed five years of follow-up. That’s a 53% dropout rate. The five-year success figures apply only to the people who stuck with the program, not to everyone who started it. If you count all original participants, the reversal and remission percentages are considerably lower.
This pattern is common across dietary interventions. Sustaining any major change in eating habits over years is difficult, and very low-carb diets in particular require eliminating foods that are central to most people’s daily meals: bread, rice, pasta, fruit juice, most desserts. Some people find the transition manageable once they adapt; others find it unsustainable over the long term.
The program also works best for people whose type 2 diabetes is primarily driven by insulin resistance rather than significant loss of insulin-producing capacity. If your pancreas has already lost most of its ability to make insulin (which tends to happen the longer diabetes goes untreated), dietary changes alone are less likely to achieve full reversal. Virta’s clinical team evaluates this during onboarding, but it’s worth understanding that not everyone with type 2 diabetes is an equally strong candidate.