More than half of younger adults with early-onset type 2 diabetes achieved disease remission within six months by following an intensive program combining a low-calorie diet and supervised exercise, according to findings from the RESET for Remission trial published in The Lancet Regional Health – Americas.
Participants in the intensive lifestyle intervention achieved a 54% remission rate at 24 weeks, compared with just 4% of participants receiving routine medical care. The randomized trial enrolled 96 adults aged 18 to 45 who were living with obesity and early-onset type 2 diabetes across research centers in England and Canada.
Researchers Test Lifestyle Changes for Diabetes
Researchers from McGill University in Canada and the University of Leicester in the United Kingdom designed the trial to test whether structured lifestyle changes could reverse early-onset type 2 diabetes, a condition known for a more aggressive clinical course and earlier complications than diabetes diagnosed in later life. None of the trial participants used insulin at baseline.
More than half of younger adults with type 2 diabetes hit full remission in just six months by following a strict low-calorie diet paired with supervised strength and aerobic training. The trial enrolled 96 adults under 45 living with obesity and early-onset type 2 diabetes. The… pic.twitter.com/ubnTA5mmbl
Under medical supervision, participants in the intervention group discontinued their blood sugar and blood pressure medications and began a daily diet providing 800 to 900 calories. During the first two weeks, all meals were replaced with specially formulated nutritional products. From weeks three to 12, participants added one conventional meal per day consisting of lean protein, fruit, and vegetables. The program also incorporated twice-weekly supervised aerobic and resistance training sessions alongside one independent workout each week. The final 12 weeks of the 24-week program involved weight maintenance and independent exercise.
To meet the medical definition for remission, patients were required to maintain an HbA1c blood sugar measurement below 6.5% for at least 12 weeks while completely off all glucose-lowering medications. Statistical adjustments by the study authors indicated that participants in the intensive program were 21 times more likely to reach remission than those receiving routine care.
Preserving Lean Muscle Mass During Weight Reduction
A central focus of the RESET for Remission trial was addressing a common risk associated with rapid weight loss: the depletion of lean skeletal muscle alongside body fat. By emphasizing resistance training alongside aerobic exercise, the intervention aimed to protect metabolic health and physical function.
Participants in the intervention group shed an average of 8.4 kilograms, or approximately 18.5 pounds, over the 24-week period, compared to a mean weight loss of 1.2 kilograms in the usual-care group. Trial investigators noted that patients on the program also increased their treadmill endurance, overall cardiovascular fitness, and handgrip strength.
Preserving muscle during remission-oriented weight loss may have important implications for long-term metabolic health, physical function, and disease trajectory.
Researchers, RESET for Remission trial
Dr. Kaberi Dasgupta, a McGill University professor of medicine and lead researcher on the study, emphasized that the trial demonstrated the practical feasibility of combining substantial dietary changes with structured workouts for young adults. Participants attended a median of 17 out of 20 scheduled supervised gym sessions, and only 10% of participants failed to complete the final evaluations.
Participants Report Mild Side Effects During Trial
While no serious adverse medical events occurred during the trial, the demanding regimen produced side effects during the early stages of calorie restriction. Approximately 86% of participants in the intervention group reported mild to moderate symptoms, including headaches, fatigue, dizziness, and constipation.
Prof Juleen Zierath, a professor of clinical integrative physiology at the Karolinska Institute who moderated the RESET for Remission session at the annual meeting of the European Association for the Study of Diabetes in Milan, discussed addressing early-onset diagnoses to prevent decades of pharmaceutical dependency and associated complications.
Earlier coverage: Study finds metabolic surgery achieves 58% diabetes remission rate
🩸 TYPE 2 DIABETES REMISSION BREAKTHROUGH? A strict low-calorie diet paired with supervised strength and aerobic training helped 54% of adults under 45 achieve type 2 diabetes remission within six months. Only 4% of those receiving standard medical care reached the same…
