Type 2 diabetes (T2D) plagues hundreds of millions of people worldwide. T2D incidence among U.S. adults currently tops 9.2% overall according to the latest CDC statistics. The disease rate increases with age, topping out at 25% for adults 65 and older. We have covered loads of products for people with T2D, from Cardiogram’s wearables that detect early signs of diabetes to Medtronic’s closed-loop artificial pancreas implementation that combine continuous glucose monitoring with a programmable insulin pump.

A new — and likely controversial — five-year study questions standard approaches to T2D. Led by researchers from Purdue University and academic institutions from California, Washington, Missouri, and Ohio, the group also includes IU Health Arnet and Virta Health. In the first year of the program, the group found the combination of nutritional ketosis and a mobile health app safely reversed type 2 diabetes. Published in Diabetes Therapy, the authors of the study state from the offset that it goes against conventional beliefs. “Our results push against the accepted norm that A1c cannot be improved while taking patients off of medication,” study leader Dr. Susan Hallberg said. “Our trial shows we did both—sometimes in a matter of weeks—and sustained and even improved results at one year. Establishing the right intervention and remote support resources is critical for our treatment approach.”

Five critical factors in the program included access to a health coach, a physician for medication management, biomarker feedback, nutrition and behavior change education, and an online community. Ketogenic diets have avid proponents and harsh critics. The Purdue-led study appears to have appropriate controls. Patients in the control group receive “usual care” from their own physicians and dietitians, following American Diabetes Association recommendations. Patients in the test group follow an individualized, low-carbohydrate, high-fat nutrition plan. Patients also connect with a health coach and a physician via a mobile application, which also includes educational resources.

Most but not all nutritional experts advise against staying on ketogenic diets indefinitely. It will be interesting to see how this program works out over the five-year duration. It’s common knowledge a healthy diet and exercise can help stave off diabetes T2, but just knowing what can help prevent the disease hasn’t stemmed its growth. If a monitored ketogenic diet with additional support proves capable of turning T2D around, the eventual impact could be wonderful, saving lives and healthcare costs at the same time.