A new clinical trial has found that a combined diet and exercise program can help younger adults with type 2 diabetes achieve remission. Researchers reported that 54% of participants who followed an intensive regimen achieved remission within six months, compared to only 4% of those receiving standard care.
The RESET for Remission trial, conducted by researchers at McGill University, the University of Leicester, and the University of Alberta, focused on early-onset type 2 diabetes, which can be particularly aggressive compared with diabetes diagnosed later in life. The findings were presented at the Annual Meeting of the European Association for the Study of Diabetes and published in The Lancet Regional Health Americas.
The 96 participants, all aged 18 to 45 with obesity and not using insulin, were split into two groups. During the first 12 weeks, the intervention group followed a daily diet of 800 to 900 calories and undertook supervised aerobic and resistance exercise twice per week, plus a third independent session. The control group continued with their usual medical care.
After 24 weeks, 27 of the 50 participants in the intervention group had met the remission criteria: their blood sugar was below the diagnostic threshold and they had taken no glucose-lowering medication for at least 12 weeks. Among participants with available weight data, weight loss averaged 8.4 kg in 47 intervention participants, compared to 1.2 kg in 43 control participants, with much of the difference coming from reduced body fat.
Side effects were more common in the intensive program, with at least one adverse event occurring in 43 of 50 participants, such as constipation, headaches, or fatigue, particularly in the early weeks of the restrictive diet. No severe adverse events were reported.
The researchers said the results suggest muscle mass can be preserved during rapid weight loss with resistance training, which they said may have important implications for long-term metabolic health. The authors said: 'Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise with a low energy diet in early-onset type 2 diabetes, supporting its potential to deliver substantial and holistic health and well-being benefits alongside diabetes remission.'
The researchers called for longer-term studies to assess how well participants can sustain their results after transitioning away from the structured trial environment.
Analysis
Why This Matters
- Provides a non-pharmacological pathway to remission for a growing population of younger adults with an aggressive form of type 2 diabetes.
- The combination of resistance training with caloric restriction addresses muscle loss, a common side effect of rapid weight loss that harms long-term health.
- Could reshape treatment guidelines and healthcare resource allocation for early-onset diabetes management.
Background
Early-onset type 2 diabetes is increasingly prevalent globally and is associated with faster declines in pancreatic function and shorter life expectancy than later-onset diabetes. Previous studies showed very low-calorie diets alone could induce remission, but the effect of adding structured exercise to preserve muscle and improve cardiovascular fitness had not been rigorously tested in this demographic until the RESET for Remission trial.
What to Watch
- Whether the high remission rates can be sustained in longer-term follow-up studies, a key caveat the researchers themselves emphasise.
- The potential for healthcare systems to develop scalable, supervised lifestyle programs for younger patients with type 2 diabetes.
- If the findings influence treatment strategies for those planning pregnancy, a group the authors specifically highlight.
Checked
12 claims in this story checked against 1 source: 12 supported.
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- SupportedThe trial's intensive program helped 54% of participants achieve type 2 diabetes remission within six months.Latest Science News -- ScienceDaily: “After 24 weeks, 27 of the 50 participants following the diet and exercise program had achieved remission, representing 54% of the intervention group.”
- SupportedThe intervention combined a low-calorie diet with exercise, and more than half of its participants achieved remission, compared with 4% receiving standard care.Latest Science News -- ScienceDaily: “In comparison, just two of the 46 participants receiving standard care reached remission, or approximately 4%.”
- SupportedThe researchers reported that the findings were presented at the EASD Annual Meeting and published in The Lancet Regional Health Americas.Latest Science News -- ScienceDaily: “The findings, presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) and published in The Lancet Regional Health Americas”
- SupportedEarly-onset type 2 diabetes can be particularly aggressive compared with diabetes diagnosed later in life.Latest Science News -- ScienceDaily: “Type 2 diabetes diagnosed at a younger age can be particularly aggressive.”
- SupportedThe trial involved researchers at McGill University, the University of Leicester and the University of Alberta.Latest Science News -- ScienceDaily: “The randomized clinical trial took place at three research centers in England and Canada (affiliated with the University of Leicester, UK, McGill University (Montreal), and the University of Alberta, Edmonton).”
- SupportedThe trial enrolled 96 participants aged 18 to 45 with obesity who were not using insulin.Latest Science News -- ScienceDaily: “It enrolled adults aged 18 to 45 who had early-onset type 2 diabetes and obesity but were not using insulin.”
- SupportedFor the first 12 weeks, the intervention group followed a daily 800-to-900-calorie diet and did supervised aerobic and resistance exercise twice weekly, plus one independent session each week.Latest Science News -- ScienceDaily: “The other followed an intensive program that combined a daily intake of 800 to 900 calories with supervised aerobic and resistance exercise twice per week, plus one independent exercise session each week (weeks 1-12).”
- SupportedRemission required blood sugar below the diagnostic threshold and no glucose-lowering medication for at least 12 weeks.Latest Science News -- ScienceDaily: “To qualify, participants needed an HbA1c level below 6.5%, equivalent to 48 mmol/mol, and must have taken no glucose-lowering medication for at least 12 weeks.”
- SupportedAmong participants with weight data, average weight loss was 8.4 kg for 47 intervention participants and 1.2 kg for 43 control participants, with much of the difference from reduced body fat.Latest Science News -- ScienceDaily: “Among the 47 intervention participants with available weight data, average body weight fell from 100.7 kg to 92.3 kg, a reduction of 8.4 kg over 24 weeks. The 43 control participants with available weight data started at an average of 103.2 kg and lost just 1.2 kg”
- SupportedAt least one adverse event occurred in 43 of 50 intervention participants, and side effects included constipation, headaches and fatigue, particularly early in the restrictive diet.Latest Science News -- ScienceDaily: “At least one adverse event occurred in 43 of the 50 intervention participants”
- SupportedNo severe adverse events were reported.Latest Science News -- ScienceDaily: “No severe adverse events were reported during the trial.”
- SupportedThe authors said: “Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise with a low energy diet in early-onset type 2 diabetes, supporting its potential to deliver substantial and holistic health and well-being benefits alongside diabetes remission.”Latest Science News -- ScienceDaily: “Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise with a low energy diet in early-onset type 2 diabetes, supporting its potential to deliver substantial and holistic health and well-being benefits alongside diabetes remission.”