Blue Shield of California increases services to address Type 2 Diabetes; structural barriers to diabetes care remain


Hannah Saunders


On Feb. 7th, Blue Shield of California announced an expanded partnership with Virta Health—a leading organization in Type 2 Diabetes (T2D) reversal—to implement digital diabetes reversal solutions under the health plan’s statewide provider network for 2023. Blue Shield is the first health plan in the state to implement Virta to members across numerous lines of business.

Virta Health combines advanced telehealth technology and clinically proven personalized nutrition to assist patients with reversing T2D and other chronic metabolic conditions. Virta Health is available to Blue Shield members enrolled in the Preferred Provider Organization plans for individuals and families, fully insured, administrative services only, and Medicare Advantage. 


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“After seeing the life-changing results achieved for our members through Virta and Wellvolution, we were convinced we should offer Virta more broadly under Blue Shield’s benefits program,” Chief Medical Officer Susan Fleischman, MD, said. “We believe this virtual diabetes-specific network partnership will produce positive lifestyle changes and improved health for our members who suffer from diabetes.”

Since 2019, Blue Shield members with diabetes who enrolled in Wellvolution digital apps lifestyle program have had access to Virta, and since, Virta has assisted Wellvolution participants with achieving positive outcomes in blood sugar control, weight loss, and reducing and eliminating the need for diabetes medications.

For Blue Shield members who’ve been using Virta Health on Wellvolution, results after one year include:

  • Insulin dosages were reduced by nearly 70%, and members eliminated over half of diabetes medication, excluding metformin.
  • Members saw on average 7% weight loss, with 5% considered as clinically significant.
  • Members saw an estimated A1c improvement of 1.1% on average. A1c is a 3-month average measure of blood glucose levels, and a lower A1c reduces the risk of long-term diabetes complications.

Over 11% of the US population, or about 37.3 million people, has diabetes. It is the most expensive disease in the world. According to the American Diabetes Association, California has the largest population of diabetics in the country and has the highest costs at nearly $40 billion each year. Care for people with diabetes accounts for 25% of healthcare dollars in the US, and more than half of that expenditure is directly contributed to diabetes.

“More than 3.2 million Californians are suffering unnecessarily from type 2 diabetes,” CEO and Founder of Virta Health Sami Inkinen said. “Our expansion with Blue Shield is a great step towards finally reversing the human and financial toll of diabetes in the state.”

With T2D, one’s body doesn’t properly produce insulin and sometimes requires insulin or medication for management. Insulin is a hormone made by the pancreas, and acts as a key to let blood sugar into cells for the body to use as energy. When cells don’t respond normally to insulin, it can lead to insulin resistance. To get the cells to respond, the pancreas may produce more insulin, but eventually the pancreas can’t keep up and blood sugar levels rise, which may lead to T2D. Symptoms for T2D develop over several years and may go unnoticed.

Contrary to popular belief, risk factors for T2D go beyond family history, a diet high in carbs and sugar, and physical activity. People of color are more likely to develop T2D, including African Americans, Asian Americans, and individuals who are Hispanic or Latino. Individuals who are Hispanic or Latino are the most affected by T2D. According to the CDC, US adults have a 40% chance of developing T2D, while Hispanic and Latino adults have over a 50% chance of developing T2D, and are more likely to develop it at a younger age. 

While risk factors include higher levels of insulin resistance, increased insulin secretion, and higher-than-normal levels of insulin in the blood, social determinants play a key role in the development of T2D. Social determinants include access to healthy and culturally available food; educational opportunities; economic and job opportunities; affordable and safe housing; social support; quality and affordable healthcare, including health insurance; and where people are born, live, work, and play.

A lack of positive social determinants may lead to the development of T2D, and immigrants and people of color who adopt the “American diet” have greater rates of diabetes. Racism and poverty play key roles in the development of T2D by creating additional stress, and having restricted access to healthy food and healthcare. Racism in healthcare settings can also sometimes lead to medical concerns going unaddressed. 

The Public Policy Institute of California’s California Poverty Measure measured poverty rates in California across demographic groups. Poverty data from the fall of 2021 shows:

  • 13.5% of Latino individuals in California were living in poverty.
  • 12.6% of Black individuals in California were living in poverty.
  • 11.8% of Asian and Pacific Islanders in California were living in poverty.
  • 9.9% of white individuals in California were living in poverty.

Until these systemic issues are addressed and improved statewide, eligible Blue Shield members can enroll in Virta to add a virtual diabetes specialist to the member’s care team for assistance with care management and resources.