Frequently Asked Questions
What are the highlights of the Revero program?
Revero's root-cause approach utilizes ketogenic nutritional therapy to treat chronic metabolic, autoimmune, and inflammatory conditions. Patients receive remote support from a dedicated care team, routine lab tests to monitor progress, and personalized treatment plans via the Revero app, where they log progress, communicate, and get feedback.
What is a low-carb diet?
Ketogenic nutritional therapy is a low-carbohydrate diet that shifts the body into ketosis, where it produces ketones (ketosis) to burn fat for energy instead of carbs, reducing inflammation and stabilizing blood sugar. Revero's approach emphasizes healthy protein and fat intake to improve metabolic health.
What can I eat on a low-carb diet?
A low-carb diet can include a wide variety of whole foods like meats, seafood, eggs, select vegetables and fruits, dairy, and fats such as butter, ghee, tallow, coconut oil, and avocado oil. Patients with certain conditions may need to limit certain foods that could trigger or worsen their condition. Given each patient's unique circumstances, specific recommendations are made on a case-by-case basis.
How will my carbohydrate intake be managed?
To get into fat-burning mode quickly, most patients will be advised to limit carbohydrate intake to 30 grams per day or less to achieve nutritional ketosis within a few weeks. Some patients may prefer to transition more gradually (> 30 grams) or more quickly (< 30 grams), and patients can work with their care team to determine if adjustments should be made.
What conditions does Revero treat using a low-carb diet?
Revero is ideal for patients diagnosed with conditions Revero treats, unless excluded by specific criteria provided below. In many cases, Revero patients with other conditions (e.g., cardiovascular disease, hypothyroidism) may still benefit from the program while their current providers manage the care of those conditions. Finally, Revero is also suitable for patients who do not have any conditions but wish to implement a low-carb diet to improve well-being.
How does Revero differ from traditional care?
Revero focuses on root-cause instead of prescribing medications to manage symptoms. Instead, our providers focus on reducing and often eliminating medications as a patient progresses. In addition, Revero patients avoid long wait times to see their providers and Revero offers patients a cost-effective way to receive health coaching on demand. Patients can also receive more support through our community meetings.
What is included in the program?
- Personalized nutrition: Care plans can be tailored based on the patient's health conditions, goals, and preferences.
- Medical supervision: Board-certified providers support, supervise and safely reduce medications.
- Health coaching on demand: Coaches guide patients, answer questions, advise on habits formation, and assist with patient accountability.
- Educational resources: Revero app provides extensive educational resources.
- Community meetings: Weekly meetings offer support from Revero staff, Dr. Shawn Baker, and members.
Who is a great candidate for the Revero program?
Revero is ideal for patients diagnosed with conditions Revero treats. In many cases, Revero patients with other conditions (e.g., cardiovascular disease, hypothyroidism) may still benefit from the program while their PCP or specialists manage the care of those conditions. Finally, Revero is also suitable for patients who do not have any conditions but wish to implement a low-carb diet to improve well-being.
What patients will be better served with other care models or specialists?
Patients with the following conditions will be better served by functional medicine, concierge medicine, or other specialists instead of Revero.
- Type 1 diabetes or LADA
- Active dialysis
- CKD stages 4, 5 or ESRD (creatinine > 2.0)
- Advanced heart failure (NYHA III or IV)
- Advanced liver disease
- Organ or bone marrow transplant within the past 2 years
- Active cancer or patients who have been treated for cancer within the past 12 months
- On any of the following medications: Lithium, Warfarin (Coumadin), Entresto, Chemotherapy drugs for active cancer
Are there any other requirements to enroll?
To enroll in Revero, you'll need to meet the following requirements.
- Must be age 18-79
- Reside in a Revero-licensed U.S. state
- Proficient in English
- Has and can operate a smart phone (texting ability required without assistance)
- Basic technology literacy
- Willing and ready to significantly change diet
Is Revero covered by insurance or FSA/HSA deductible?
Revero is a self-pay program and accepts FSA/HSA cards. Please check with your plan administrator to determine eligibility and documentation requirements. Revero can provide itemized receipts and letters of medical necessity as needed.
How will my provider work with me?
Revero patients meet providers in an Onboarding Call to review lab results, health history, and program suitability based on goals. After clearance, patients communicate primarily via chat within the app or by phone for follow-ups. Providers review progress and biomarkers, with labs retaken at 3, 6, and every 6 months thereafter. Medications are adjusted as needed along the way as patients progress.
Are Revero providers doctors and knowledgeable about my condition?
Revero providers include physicians and nurse practitioners, all highly trained and passionate about metabolic health and lifestyle medicine, which they practice personally and with patients. They joined Revero to support its mission of healing and reducing medication use. Each undergoes specialized Revero training to deliver exceptional care tailored to your condition.
What labs are included in the program?
Routine labs for all patients include CBC, Platelet, Nondifferential, Comprehensive Metabolic Panel, Hemoglobin (Hb) A1c, Insulin, Lipid Panel, TSH, Vitamin D 25-Hydroxy, and HS-C-Reactive Protein (CRP). Patients with type 2 diabetes may also receive additional testing to assist with insulin management.
Revero does not order any other testing than the tests listed here.
What does the health coach do?
Each patient can work with a health coach one-on-one to support adoption and transition to a low-carb diet. In a Welcome call, coaches discuss goals and support needs for diet, sleep, stress management, and fitness. Thereafter, patients contact coaches via app chat or scheduled appointments. For patients already on a low-carb diet, coaches troubleshoot stalls, relapses, and optimize plans.
How will I communicate with my care team and how often?
The Revero app is where patients will receive their care plans, educational resources, track biomarkers, and communicate with their care team via the chat feature. Patients may also use the desktop version as needed.
Can I really ask my care team questions whenever I want?
Yes, our health coaches and providers monitor chat during normal business hours and can help get you answers that you need, usually within one business day, if not sooner.
How are medications managed?
Revero providers will manage medications for Revero-treated conditions. Patients with prescriptions from other providers for non-Revero conditions should continue working with those providers. Your pharmacy will handle processing insurance coverage per their normal process.
Will Revero providers coordinate treatment with primary care physicians or other specialists?
Yes, Revero care teams can assist patients with understanding how to coordinate care with primary care physicians and other specialists who are managing non-Revero conditions.
Is calorie counting, calorie restriction, intermittent fasting, or exercise required?
Revero does not expect patients to calorie-restrict, count calories, or fast. However, managing carbohydrate intake (if consuming them) and meeting protein goals are a core part of the program. Movement throughout the day is highly encouraged to improve progress but not required.
Am I able to use Revero if I travel out of state or go abroad?
The Revero app lets patients easily connect with their care team before traveling out of state. However, U.S. laws require medical services, like lab reviews or consultations, to be provided by providers licensed in the same state at the time of service. For out-of-state trips and travel abroad, patients should consult their care team to ensure compliance and receive guidance on maintaining their care plan while away.
Please note: Revero does not serve patients residing outside the United States
Why is Revero better than doing a low-carb diet yourself?
Many people can see results on their own, but Revero providers want to ensure patients are safely adjusting medications and receiving the best possible care when implementing a low-carb diet. Also, patients who have the support of an experienced medical provider and health coach can often achieve results more efficiently and with fewer setbacks than the guesswork involved when doing it alone.
Is a referral from a doctor required for enrollment?
Revero is a self-pay program. Referrals are not required.
What does the first month of the program include after I pay?
- Once you enroll at onboarding.revero.com and pay, your membership begins.
- Next you will complete the secure, HIPAA-compliant health information forms to provide your medical history and other important information.
- Once that is submitted, you'll perform lab work. These initial lab tests will be reviewed by your provider.
- Next, you'll schedule a Provider Onboarding call. During this call, your provider will discuss goals, review medical history, conditions, and results to confirm suitability for the program.*
- Once cleared for the program, you will receive an email invitation to download the Revero app to access their care team and educational resources.
- To round out the month, you'll schedule a Coach Welcome Call. During this call, coaches review care plans, set goals, and establish a diet start date to begin their Revero journey.
*If there are circumstances that are identified during the Provider Onboarding call that would make a patient ineligible for the program, everything paid will be refunded with the exception of $125 to cover the cost of provider time.
What is Remote Device Monitoring?
- Revero provides connected monitoring devices to eligible patients so your care team can track key health metrics between appointments, directly through the Revero app.
- For type 2 diabetes, you will receive a glucose monitor that syncs with the Revero app, along with strips, lancets, and alcohol swabs. Glucose test strips are replenished automatically throughout your membership.
- For hypertension, you will receive a blood pressure cuff and monitor that syncs with the Revero app.
- Your care team reviews your data in real time, allowing them to make timely, informed adjustments to your care plan.
How easy is it to cancel my membership?
You may cancel by emailing support (email listed on the site) or within the app. Please keep in mind Revero does not offer prorated or partial refunds for early cancellations.
How easy is it to sign up?
Visit onboarding.revero.com to begin enrollment or call 1-415-835-4151 to speak to an enrollment advisor if you need more help. We look forward to being a part of your health journey.
What conditions is the Revero program NOT suitable for?
While many patients see broad health improvements on the Revero program, the program isn't a substitute for specialty care. Revero would not be a good fit for patients primarily seeking: hormone replacement therapy, thyroid medication management, psychiatric care for complex conditions, neurological disease management, cardiovascular risk or lipid management, or gout/kidney stone treatment.
What is ketogenic nutritional therapy?
Ketogenic nutritional therapy is a low-carbohydrate diet that shifts the body into ketosis, where it produces ketones (ketosis) to burn fat for energy instead of carbs, reducing inflammation and stabilizing blood sugar. Nutritional ketosis has been shown to improve inflammation, blood sugar stability, and weight loss. Revero's approach emphasizes healthy protein and fat intake to improve metabolic health.
Is ketosis safe?
A personalized care plan based on your individual biomarkers is safe. If you are taking prescription medications, your Revero care team will work closely with you and other providers managing your care to ensure safety. Patients may see rapid changes, requiring the need to change medications in response.
What does keto-adaptation or becoming fat adapted mean?
This is the process in which your body changes from running primarily on glycogen (glucose via dietary carbohydrates) to ketones (healthy fats) as its energy source. Becoming fat adapted is a long-term metabolic state in which your body has switched from burning glucose to using fats for energy.
How can a ketogenic diet help me to lose weight?
Well-formulated ketogenic diets have been shown to help with weight loss and more importantly, your overall health. The rate of the weight loss is dependent on a few factors which you can discuss with your care team.
How can I measure ketosis?
In addition to physical signs like fat loss, ketone production can be measured by using urine test strips at home. Ketones can also be measured at home using a device that specifically tests for ketone levels in the blood.
What can I eat on a ketogenic diet?
A ketogenic diet can include a wide variety of whole foods like meats, seafood, eggs, select vegetables and fruits, dairy, and fats such as butter, ghee, tallow, coconut oil, and avocado oil. Patients with certain conditions may need to limit certain foods that could trigger or worsen their condition. Given each patient's unique circumstances, specific recommendations are made on a case-by-case basis.
How will my carbohydrate intake be managed? (ketogenic)
To get into fat-burning mode quickly, most patients will be advised to limit carbohydrate intake to 30 grams per day or less to achieve nutritional ketosis within a few weeks. Some patients may prefer to transition more gradually (> 30 grams) or more quickly (< 30 grams), and patients can work with their care team to determine if adjustments should be made.
What are symptoms that may signal that I need electrolyte supplementation?
Carbohydrates can be highly inflammatory to human metabolic health. Consuming sugar sharply raises blood sugar, prompting an insulin response. Insulin, an essential hormone, moves sugar from the blood into cells for energy, storing excess glucose as glycogen or fat. High insulin levels block your body's ability to use stored fat for energy, making it difficult to lose weight. High-sugar diets have also been associated with chronic diseases such as type 2 diabetes, heart failure, strokes and high blood pressure.
What are artificial sweeteners and sugar substitutes I can use on a ketogenic diet?
It may be better to avoid foods requiring added sweeteners on a ketogenic diet, as they may disrupt ketosis and trigger cravings. Low-impact sweeteners like liquid stevia, monk fruit, and xylitol are acceptable in moderation. If sweetness is desired, whole food choices like berries can offer a more natural alternative while on a low-carb diet.
Which fats are best on a ketogenic diet?
Saturated and monounsaturated fats from animal and plant sources are recommended. This includes beef tallow, lard, butter, olive oil and avocado oil. It is best to avoid processed or highly refined oils such as canola, soybean, cottonseed, corn, grapeseed, sunflower, and safflower. These oils are also higher in polyunsaturated fatty acids which lead to inflammation.
How much protein will I need to eat?
While individuals differ, the recommendation for most people is to eat roughly between 1.5 to 2 grams of protein per kilogram of ideal body weight to maintain lean body mass.
What about whey protein on a ketogenic diet? Is this okay?
There are pros and cons to supplementing with whey protein while on a ketogenic diet. Whey has essential amino acids but produces higher insulin secretion than other proteins like meat and eggs. Whey also lacks sufficient potassium, magnesium and phosphorus and is not a complete protein like meat, fish, or eggs. Thus, whey is not recommended in the Revero program.
Can I be vegetarian or vegan on a ketogenic diet?
It is possible. Please consult with your Revero care team if this is your preference.
Is there a need to eat vegetables on a ketogenic diet?
There can be benefits to consuming non-starchy, low-carbohydrate vegetables, which provide fiber, vitamins, and minerals that can help patients adapt to a ketogenic diet. However, consuming vegetables is not required for those on a strict carnivore diet.
Do I have to take supplements on a ketogenic diet?
Supplementation isn't required with Revero's whole-food ketogenic therapy since micronutrients are better absorbed from food. In hot, humid climates or with heavy exercise, electrolytes (sodium, magnesium, potassium) may help. Vitamin D is beneficial if you're indoors often or lack sun exposure.
How can reducing carbohydrate intake improve health?
- Sodium: If you're feeling weak, fatigued, or experiencing headaches, increasing your sodium intake can help. Use electrolyte packets and add extra salt to your meals. The electrolyte packets contain all three minerals.
- Potassium: Muscle cramps and irregular heartbeats can be signs of low potassium. Incorporate potassium-rich foods like avocados and leafy greens. Potassium is also included in the recommended electrolyte packets.
- Magnesium: If you're experiencing muscle cramps, insomnia, or anxiety, you might need more magnesium. Consider magnesium-rich foods or supplements. With Revero, magnesium supplementation is generally recommended when starting on a low-carbohydrate diet. People may choose to use the electrolyte packets recommended by Revero or purchase their own supplement such as magnesium glycinate. The recommended dose for the supplement is 300-400 mg daily unless advised otherwise by the medical provider.
Do I need to take fiber supplements?
Fiber supplements are unnecessary for those eating a well-planned ketogenic diet with vegetables that contain fiber. Similarly, those on diets higher in fats may also discover that fiber supplements are unnecessary to maintain regular bowel movements.
Is a ketogenic diet safe for my heart?
Yes. A well-formulated ketogenic plan is safe and can improve metabolic health by reducing inflammation, which is linked to heart disease. For most people, a ketogenic diet improves cholesterol numbers, but for some people there are temporary rises in cholesterol during weight loss that can be discussed with your Revero care team.
Can I salt my food on a ketogenic diet? What about my blood pressure?
Yes, by following your nutrition plan, an increase in salt intake can be done modestly without raising blood pressure. Your Revero care team can help ensure your salt intake is appropriate to maintain good health.
What if I don't have a gallbladder?
If you've had your gallbladder removed, you may find it difficult to digest high amounts of fat at one time. While it is safe to eat fat, people without gallbladders tend to lean toward eating leaner meats or spreading out fat consumption throughout the day.
What about “keto flu?” How can I avoid it?
Some patients may experience flu-like symptoms in the first few days or weeks. Symptoms like lightheadedness, fatigue, headache, constipation, and nausea may occur during rapid weight loss as the body shifts from retaining to expelling salt and water. Replenishing electrolytes (sodium, potassium and magnesium) can help.
What else could happen while on a ketogenic diet?
Whenever making any dietary change, diarrhea, constipation, or rashes may occur in some people as the body adapts to a new diet and detoxifies from high-carb foods and processed chemicals standard in the Western diet. Your Revero care team will help address this as needed.
How do type 1 and type 2 diabetes differ?
Type 1 diabetes results from insulin deficiency due to pancreatic damage from an autoimmune condition destroying insulin-producing cells in the pancreas. On the other hand, type 2 diabetes stems from insulin resistance. The pancreas produces insulin but the body becomes less responsive to it over time. Insulin normally signals the body to store food energy, shuttling it into cells.
Type 1 diabetes necessitates lifelong insulin injections due to the pancreas's inability to produce insulin. In contrast, in type 2 diabetes, increasing insulin levels become necessary to store glucose until the body can no longer manage it. This causes elevated glucose levels.
Reducing carbohydrate intake to low-carb ketogenic levels of 30 grams is an effective approach to treating type 2 diabetes.
What is diabetic ketoacidosis (or DKA) and who can develop it?
DKA is a serious medical emergency that mainly affects those with type 1 diabetes. It results from excess ketone production due to insufficient insulin and high blood glucose. Triggers for patients with type 1 diabetes include missed meals, skipping insulin, or fighting infections.
Without insulin, glucose cannot enter cells and be used for fuel. This forces the body to break down fats rapidly. The excessive rise in ketone bodies as byproducts causes acid buildup in the blood and can lead to organ failure, coma, or even death.
While rare in type 2 diabetes, DKA can occur due to medication issues, sudden insulin discontinuation, or the pancreas's failure to produce enough insulin.
How does Metformin work?
Metformin primarily reduces liver glucose production and enhances insulin sensitivity. Though its exact mechanism isn't fully understood, it's widely used as the initial treatment for type 2 diabetes. It is inexpensive and safe, with minimal side effects or long-term risks.
Metformin does not cause low blood sugar and is deemed safe with a low-carb diet. Moreover, metformin has also been shown to help prevent type 2 diabetes. It is utilized off-label for other insulin resistance conditions like prediabetes and PCOS and can aid in weight loss.
Are there early warning signs before type 2 diabetes develops?
Typical symptoms associated with diabetes are excessive thirst, blurred vision, frequent urination, and tingling extremities. These are actually signs of the condition itself rather than the initial insulin resistance that precedes it.
Early warning signs of insulin resistance can start months and years before type 2 diabetes develops or traditional blood sugar or HbA1c tests are elevated. Early signs can include:
- Fatigue
- Weight gain
- Elevated blood pressure
- New skin tags
- Darkened skin patches (acanthosis nigricans)
- Paradoxically, signs of low blood sugar
Symptoms of low blood sugar happen when a person hasn't eaten for an extended period, leading to a sensation of being “hangry” (hungry and irritable). This situation hints at high insulin levels due to insulin resistance, causing delayed glucose storage followed by an excessive drop in blood sugar levels.
How can I find out if I have diabetes?
The 2022 guidelines from the American Diabetes Association (ADA) recommend all adults age 35 or older be screened at least once every 3 years for diabetes. ADA also recommends that all adults of any age who are overweight or obese be screened.
There are a few tests that are used to diagnose type 2 diabetes that your doctor can order:
- A fasting glucose level 126 mg/dL or greater
- Hemoglobin A1C 6.5% or over
- If an oral glucose test shows elevated glucose
- If your blood sugar ever tests over 200 mg/dl
Some specific symptoms and observations also could make you suspect type 2 diabetes which should prompt you to see your doctor (see next section).
What are signs and symptoms of type 2 diabetes?
Symptoms of type 2 diabetes can vary in severity and may develop slowly and seem unrelated, making them easy to overlook or attribute to other causes. If you have some of these symptoms, get a medical evaluation.
Common signs and symptoms of type 2 diabetes include:
- Increased thirst and dry mouth (polydipsia).
- Frequent urination (polyuria), especially at night.
- Excessive hunger (polyphagia), even after eating.
- Unexplained weight loss despite an increase in hunger and food intake.
- Persistent tiredness, lack of energy, and a feeling of being physically or mentally drained.
- Blurred or hazy vision or seeing floaters or spots.
- Slow healing of wounds and infections: Cuts and sores taking longer to heal, and frequent infections or sores that are slow to heal.
- Tingling or numbness: Feeling “pins and needles”, numbness, or pain, especially in the hands, feet, or legs.
- Darkened skin patches (Acanthosis Nigricans): Velvety, dark patches of skin, usually on the neck, armpits, or groin.
- Impaired wound healing: Cuts, bruises, or sores that take a longer time than usual to heal.
- Irritability: Feeling easily irritable or having mood swings.
- Frequent vaginal yeast infections or urinary tract infections (women).
- Erectile dysfunction (men).
It's important to note that not everyone with type 2 diabetes will experience noticeable symptoms, especially in the early stages. Regular screenings and check-ups with a healthcare professional are essential, especially if you have risk factors like obesity, polycystic ovarian syndrome (PCOS), prior gestational diabetes, a sedentary lifestyle, a family history of diabetes, or high blood pressure.
Early detection and appropriate management of type 2 diabetes are crucial for preventing complications and maintaining overall health. If you suspect you may have diabetes or are experiencing symptoms, seek medical attention for proper evaluation and diagnosis.
Is type 2 diabetes preventable?
Yes, type 2 diabetes is largely preventable. Lifestyle modifications play a significant role in prevention. One essential step in prevention is to have a primary care provider for personalized guidance and support in diabetes prevention and screening.
Here are key strategies to reduce the risk of developing type 2 diabetes:
- Focus on a whole food diet rich in protein, healthy fats, and non-starchy vegetables. Avoid processed food, sugary beverages, excessive carbohydrates, or sugary snacks.
- Engage in regular physical activity, because just 150 minutes a week of aerobic exercise or weight lifting can aid in prevention.
- A robust connection exists between obesity and the onset of type 2 diabetes. Losing excess weight, especially around the abdomen, with a low-carbohydrate diet and exercise can significantly reduce the risk of type 2 diabetes.
- Limit alcohol consumption as much as possible. Alcohol reduces self-control and provides additional calories that need to be metabolized before body fat.
- Stop smoking, because it worsens glucose control and diabetic complications, and is simply bad for health.
- Regular check-ups for early detection and monitoring can help to identify metabolic disease before it becomes diabetes.
- Managing stress more effectively can help prevent diabetes because stress raises blood glucose and can promote diabetes.
- Adequate sleep helps to stabilize blood glucose, while insufficient sleep reduces glycemic control.
- Knowledge and education are very useful for type 2 diabetes prevention. Take time to review the learning videos and related articles. Reviewing them more than once will help you develop a better understanding of metabolic health.
What foods increase the risk of type 2 diabetes?
Scientific evidence indicates that specific foods, such as refined grains and sugary beverages are linked to a higher likelihood of developing type 2 diabetes mellitus. Trans fats or hydrogenated fats have also been shown to be associated with higher chances of type 2 diabetes.
Some types of foods can increase the risk of type 2 diabetes. Foods high in added sugars, such as sugary drinks, candies, pastries, cakes, cookies, and sweetened cereals, can cause rapid spikes in blood sugar levels.
Refined grains and processed carbohydrates like white bread, white rice, sugary cereals, and pasta can lead to rapid increases in blood sugar. Highly processed foods often contain added sugars, unhealthy fats, and refined carbohydrates, all of which can contribute to insulin resistance and promote type 2 diabetes.
Foods high in trans fats, such as fried foods and processed snacks can contribute to insulin resistance and increase the risk of diabetes.
Fruit juices may contain natural sugars, but they lack fiber, which slows down sugar absorption. Drinking fruit juices can cause rapid increases in blood sugar levels.
Excessive alcohol consumption can affect blood sugar levels and lead to weight gain, increasing the risk of insulin resistance and type 2 diabetes.
What diets can be used to prevent or treat type 2 diabetes?
For a diet to result in sustained long-term benefit, it must fit a person's budget, taste preferences, values, and of course health.
Research has shown that low-carb, ketogenic diets are helpful for controlling type 2 diabetes. By restricting carbohydrates, you are reducing the load of sugar on the body and reducing the body's need to produce more insulin, which in effect reduces insulin resistance, the primary root cause of type 2 diabetes.
Mediterranean diets have been shown to help prevent type 2 diabetes.
Reputable organizations like the American Diabetes Association and the European Association for the Study of Diabetes have issued reports affirming the benefits of low-carbohydrate diets for those with type 2 diabetes.
Revero's low carbohydrate diet and clinical protocols are designed to treat the root cause of metabolic diseases like type 2 diabetes.
The most important single step to helping prevent type 2 diabetes is talking with your PCP about what your options are, and deciding what will be best suited to your needs.
Can I use supplements to treat diabetes?
Several supplements, including cinnamon, zinc, chromium, alpha-lipoic acid (ALA), ginseng, fenugreek, green tea, and others have been evaluated for diabetes treatment. The results haven't been conclusive enough to make any recommendations.
Research suggests that berberine, derived from several plants, has shown the potential to reduce blood sugar levels by affecting various metabolic pathways. It may have a similar effect to some diabetes medications like metformin and might be useful as part of diabetes management, but don't take it without consulting with a healthcare provider.
It's crucial to consult with a healthcare provider before adding any supplements to your diabetes management plan. Some supplements may interact with medications or have side effects, and proper dosages must be determined based on individual health conditions and needs.
If I modify my diet to improve my diabetes management, how should I adjust my medication?
Revero recommends that people with type 2 diabetes should only change their diets with medical supervision. Changing your diet, particularly to Revero's low-carbohydrate diet, can be very effective at lowering blood sugar. It will require monitoring and medication adjustment as it can lead to a rapid drop in blood glucose or blood pressure to dangerous levels.
You should NOT attempt to adjust medications on your own as you will risk serious complications.
Most medical clinics are not set up to continuously monitor biomarkers, but that is part of how we designed the Revero protocol. We can adjust medications as needed, more than once a day if necessary. We sometimes even lower medications ahead of time to prevent unsafe low blood sugar levels.
What are common complications of type 2 diabetes?
Uncontrolled high blood sugar can lead to various complications affecting different parts of the body. Common serious complications of type 2 diabetes include cardiovascular complications such as heart disease, stroke, and peripheral vascular diseases.
Type 2 diabetics have a risk of fatal myocardial infarction equal to individuals who have had a previous myocardial infarction.
Chronic kidney disease (nephropathy) is also a complication of type 2 diabetes. Poor glycemic control damages the capillary beds in the kidney. The result is reduced kidney function and elevated blood pressure.
Nerve damage (neuropathy), which can be peripheral or autonomic. This creates a loss of sensation which can make the patient unable to identify injury or infections.
Eye disease (retinopathy) is also a complication of type 2 diabetes and can result in significant vision loss or even blindness.
Foot complications (diabetic foot ulcers) can occur because the patient can't feel their feet. Even a small injury can go unnoticed, become infected, and cause a large and dangerous ulceration.
Complications related to poor wound healing are common after injuries or ulcerations, due to reduced circulation. Normally, the blood supply delivers support for the healing process after injuries.
Cognitive function decline such as dementia can occur in type 2 diabetes. The loss of a stable supply of glucose for the brain promotes inflammation, oxidative stress, and damage to neurons in the brain.
Complications during pregnancy can occur from type 2 diabetes. These can include miscarriage, congenital malformations, pre-eclampsia, and more.
Individuals with type 2 diabetes must work closely with their healthcare team to manage their blood sugar levels, blood pressure, and overall health. This reduces the risk of these complications and improves quality of life.
Regular monitoring, a healthy lifestyle, and adherence to prescribed medications are key components of managing type 2 diabetes.
What is Cardiovascular Disease?
Cardiovascular disease (CVD) is a broad term that encompasses a range of conditions affecting the heart and blood vessels. These conditions can lead to various health problems, including heart attacks, strokes, angina (chest pain or discomfort), heart failure, arrhythmias (irregular heartbeats), and peripheral artery disease. Here are some key components and types of cardiovascular disease:
- Coronary Artery Disease (CAD): This is the most common type of heart disease and occurs when the blood vessels (coronary arteries) that supply blood to the heart muscle become narrowed or blocked due to a buildup of plaque (atherosclerosis). It can lead to chest pain (angina) or a heart attack (myocardial infarction). Myocardial infarction is the #1 cause of death in patients with type 2 diabetes.
- Stroke: Patients with type 2 diabetes have a greatly increased risk of ischemic stroke, and also about a 25% lower chance of a good outcome. This is thought to be the result of damage to the lining of arteries, causing inflammation and stiffness as well as thickening. Ischemic stroke occurs when a blood clot blocks or narrows an artery supplying blood to the brain.
- Peripheral Artery Disease (PAD): PAD occurs when there is a narrowing or occlusion of the arteries in the legs and other parts of the body, limiting blood flow. This condition is a major cause of diabetic foot ulcers, amputation of feet or legs, and death. The occurrence of peripheral arterial disease is estimated to be 2-7 times higher in people with type 2 diabetes than in those without the condition.
How does diabetes damage the kidneys? (Diabetic Nephropathy)
Diabetic nephropathy is a serious kidney condition that can develop in people with diabetes, particularly if the diabetes is poorly controlled. Up to 40% of diabetics develop diabetic nephropathy.
Diabetic nephropathy results from prolonged damage to the small blood vessels in the kidneys caused by high levels of blood glucose (sugar). Over time, this damage affects the kidneys' ability to filter waste products and excess fluids from the blood. It can also lead to end-stage kidney diseases requiring dialysis or kidney transplant.
Chronic kidney disease and end-stage kidney disease are most frequently caused by type 2 diabetes.
38% of patients with type 2 diabetes develop protein in their urine (albuminuria) and 29% experience impaired kidney function within 2 years.
Chronic kidney disease progresses to end-stage kidney disease requiring dialysis in as little as two years. This has been found to occur in 10-17% of type 2 diabetic patients.
How does diabetes cause nerve damage? (Diabetic Neuropathy)
Diabetic neuropathy is a type of nerve damage that can occur in individuals with diabetes, particularly those who have had diabetes for a significant period. Elevated levels of glucose in the blood over an extended period can damage the nerves throughout the body.
The symptoms of diabetic neuropathy can vary depending on the type of nerves affected. The most common types of neuropathy are:
- Peripheral neuropathy: Affects the peripheral nerves usually in the legs and feet, causing pain, numbness, and tingling. It can also cause sensory loss or altered sensation, making it difficult to perceive temperature or pain. Muscle weakness and difficulty coordinating movements can also happen.
- Autonomic neuropathy: Affects the nerves controlling involuntary bodily functions like bladder problems, gastrointestinal issues (gastroparesis), sexual dysfunction, and changes in heart rate (arrhythmia) and blood pressure.
How does diabetes damage eyesight? (Diabetic Retinopathy)
Diabetic retinopathy occurs in patients with type 2 diabetes who have elevated blood glucose levels. The risk of diabetic retinopathy increases with the amount of time you have type 2 diabetes. High glucose levels cause damage to the circulation of the retina.
Diabetic retinopathy may be either proliferative or nonproliferative. Nonproliferative retinopathy occurs when high blood glucose levels lead to a breakdown of the structural walls of blood vessels in the retina.
Proliferative diabetic retinopathy is when the blood vessels no longer function, and the body grows new blood vessels to replace them. The new ones are also not normal and develop leaks.
As new blood vessels grow, the retina can detach from the back of the eye, causing vision loss. Glaucoma can also result from the growth of new blood vessels.
Diabetic retinopathy can cause different symptoms, such as loss of color vision or blurry vision. Those symptoms are slow to develop though, and anyone who has diabetes should have regular eye exams to detect retinopathy early.
Diabetic retinopathy does not occur in everyone with type 2 diabetes. If you have type 2 diabetes, controlling your blood glucose level could help prevent severe vision loss or delay the worsening of retinopathy.
There are treatments for advanced diabetic retinopathy. The choice of treatments depends on the state of a person's retina.
Can a low-carb diet improve diabetic neuropathy, retinopathy, or nephropathy?
There is no good published peer-reviewed research that shows objective improvement of these conditions in type 2 diabetes following a low-carb diet. However, there are many anecdotes of people improving these conditions over time with a low-carb or ketogenic diet.
How does type 2 diabetes cause foot problems?
When you have diabetes, your feet can develop many different complications. These problems are the result of nerve damage, blood vessel problems, and delayed healing.
Diabetic neuropathy occurs when the nerves are damaged by diabetes, causing loss of the sensations of pain, cold, or heat in the feet. This results in changes to the foot and toes known as a “Charcot foot”.
If you have diabetic neuropathy, the nerve damage can make you unaware of injuries to your feet. You can sustain wounds, cuts, blisters, scrapes, or ulcers and not feel it. Because of the delayed healing, getting these to heal properly without infections is challenging.
Diabetes can also result in damaged blood vessels, reducing circulation and contributing to delayed healing and resultant infections. Even antibiotics become less effective because the bloodstream normally delivers the antibiotic to the site of the infection in the feet or toes. These types of wounds can take weeks or months to heal.
Fungal infections, corns, and calluses can also develop from diabetes. Often there is hair loss on the lower legs, feet, and toes.
How can diabetic foot problems be treated?
The best strategy is prevention, by examining your feet every day and preventing foot injuries. Controlling blood sugar, blood pressure, and blood lipids can also slow the underlying causes of diabetic foot issues by preventing or slowing blood vessel and nerve damage.
Warning signs are swelling, redness, blisters, ulcers, or calluses and should be reason to immediately contact your medical provider. Doing this will help to make sure that small wounds or infections get attention before becoming worse. Antibiotics are often used for infections. Dressings and medications are used on wounds, to help the foot heal.
These types of diabetic foot problems can sometimes result in wounds that don't heal or become very infected, and this can necessitate surgery or even amputation. Prevention is by far the better path, so get evaluated by your medical provider immediately when lesions are noticed.
