Type 2 diabetes breakthrough as 54% achieve remission in just 6 months

Type 2 diabetes breakthrough as 54% achieve remission in just 6 months - Date: - October 30, 2026 - Source: - European Association for the Study of Diabetes - Summary: - A promising new study suggests that more than half of younger adults with type 2 diabetes could achieve remission in just six months through a combination of a low-calorie diet and structured exercise. Researchers found that 54% of participants under age 45 who followed an intensive diet and exercise program achieved remission, compared with just 4% receiving usual care. - Share: A carefully structured combination of diet and exercise may offer a powerful way to put type 2 diabetes into remission in younger adults. In a new clinical trial, more than half of participants who followed an intensive lifestyle program achieved remission within just six months, compared with only 4% of those receiving standard care. 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, suggest that a low-calorie diet paired with regular exercise could significantly change the course of early-onset type 2 diabetes (EOT2D) (aged under 45 years). The research was conducted by Professor Kaberi Dasgupta, Director of the Division of General Internal Medicine at McGill University in Montreal, Canada, Professor Thomas Yates of the University of Leicester in the UK, and their colleagues. Why Early-Onset Type 2 Diabetes Is Especially Dangerous Type 2 diabetes diagnosed at a younger age can be particularly aggressive. People with early-onset type 2 diabetes (EOT2D) often experience a faster decline in blood sugar control, develop complications earlier in life, and face a shorter life expectancy than those diagnosed at older ages. Previous research has shown that very low-calorie diets (LEDs) can lower blood sugar enough for some people to achieve remission without diabetes medication (T2D remission). Remission means blood sugar has fallen below the threshold used to diagnose diabetes and remains there without glucose-lowering drugs. However, it does not necessarily mean the disease has been permanently cured. Researchers wanted to find out whether adding structured exercise could make this approach even more effective. Beyond helping regulate blood sugar, physical activity could improve fitness, protect muscle during weight loss, strengthen heart function, and reduce insulin resistance. To investigate, the team tested whether combining a low-calorie diet with supervised exercise could achieve remission after 24 weeks, compared with standard medical care. An Intensive Diet and Exercise Program 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). It enrolled adults aged 18 to 45 who had early-onset type 2 diabetes and obesity but were not using insulin. The trial was open-label, meaning participants and researchers knew which treatment each person received, although the assessment of the main outcome was blinded. One group continued receiving usual care. 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). Participants then transitioned to a diet designed to maintain their weight loss while continuing to exercise independently (weeks 13-24). The researchers measured how many participants achieved diabetes remission after 24 weeks. 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. HbA1c is a blood test that reflects average blood sugar levels over approximately three months. The analysis included everyone assigned to either group. When remission data were missing, researchers conservatively counted those participants as not having achieved remission. They also examined changes in cardiovascular fitness, body composition, and heart structure. What Participants Ate During the Study At the beginning of the intensive program, participants discontinued medications used to lower blood sugar and blood pressure (in the absence of albuminuria), under the study's medical supervision. Albuminuria refers to the presence of a protein called albumin in urine and can indicate kidney damage. Their restricted diet provided 800 to 900 calories daily (30% protein, 50% carbohydrate, 20% fat). Participants were encouraged to drink at least two liters of calorie-free fluids each day and were given access to a fiber-based laxative when needed. During the first two weeks, all meals were replaced with specially formulated nutritional products (Optifast). From weeks three through 12, participants maintained the same calorie limit but gained more flexibility in their food choices (Optifast in UK and ProtiDiet in Canada). This second phase allowed one conventional meal per day, with daily intake targets that included protein, fruit, and vegetables (60 to 90 g protein from all sources combined, one portion of fruit, two portions of non-starchy vegetables). After the first 12 weeks, participants shifted toward maintaining their weight loss rather than continuing rapid weight reduction. More Than Half Achieved Type 2 Diabetes Remission Between September 24, 2021, and June 6, 2025, the researchers enrolled and randomly assigned 96 participants (40 UK, 56 Canada). The group included 50 people assigned to the intensive intervention and 46 receiving standard care (24 female, 26 male intervention group; 21 female, 25 male control group; mean age 38 years, BMI 35·2 kg/m2). Of those enrolled, 86 (90%) completed the final assessments. The results revealed a striking difference between the groups. After 24 weeks, 27 of the 50 participants following the diet and exercise program had achieved remission, representing 54% of the intervention group. In comparison, just two of the 46 participants receiving standard care reached remission, or approximately 4%. After accounting for relevant statistical factors, the researchers calculated that participants in the intensive lifestyle program were 21 times more likely to achieve remission than those receiving usual care. Weight loss was also substantially greater among participants following the combined program. 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, reaching 102.0 kg. After statistical adjustment, the intervention group lost an average of 7.5 kg more weight than the control group. Importantly, this included an additional 6.6 kg of fat loss, indicating that much of the difference came from reduced body fat. Promising Results With Manageable Side Effects No severe adverse events were reported during the trial. However, side effects were more common among participants following the intensive diet. At least one adverse event occurred in 43 of the 50 intervention participants, compared with six of the 46 participants receiving standard care. Most problems appeared during the early stages of the restrictive diet and included symptoms such as constipation, headaches, dizziness, and fatigue (e.g., constipation, headache, dizziness, fatigue). These effects generally resolved. The researchers believe the findings demonstrate that a combined diet and exercise intervention can produce meaningful improvements beyond blood sugar control alone. The authors say: "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. "Our remission rates are at the upper end of those previously reported in the literature for trials of similar duration, reinforcing the potential of structured lifestyle interventions to support clinically meaningful remission, while demonstrating for the first time that such effects can be achieved in a multi-ethnic population with early-onset type 2 diabetes through a combined low-energy diet and structured exercise intervention." Why Preserving Muscle During Weight Loss Matters One particularly important aspect of the study was its emphasis on protecting muscle mass during rapid weight loss. The researchers explain that most people who complete weight loss programs eventually regain some or all of the weight they lost. This is especially relevant when using very low-calorie diets to achieve diabetes remission. Losing weight through calorie restriction alone typically reduces both fat and fat-free mass, which includes muscle. Some evidence suggests that when weight returns, the body may regain proportionally more fat than lean tissue. Over time, repeated weight loss and regain could therefore contribute to a gradual reduction in muscle mass and increase the risk of sarcopenia, a condition characterized by declining muscle mass and strength. To address this problem, the researchers incorporated resistance training into the most intensive phase of weight loss. Their results suggest that it is possible to achieve substantial fat loss while preserving muscle, potentially making the approach more beneficial for long-term metabolic health. They say: "Our RESET for Remission study targeted muscle during the intensive weight loss phase through resistance training, and our findings indicate fat-free mass and muscle preservation is achievable with rapid weight loss. Preserving muscle during remission-oriented weight loss may have important implications for long-term metabolic health, physical function, and disease trajectory. This requires examination in a longer-term study." A Potential New Approach to Treating Type 2 Diabetes The findings could be particularly important as type 2 diabetes becomes increasingly common among younger adults worldwide. People who develop the condition earlier in life face more years of exposure to elevated blood sugar, increasing their lifetime risk of cardiovascular disease and other complications. Finding effective ways to achieve remission early could therefore have substantial health benefits. The researchers emphasize that their intervention did more than lower blood sugar. It also reduced body fat while protecting muscle, improved muscle quality and physical performance, supported cardiovascular health, and produced improvements in participants' reported well-being. They also suggest that this strategy could be especially relevant for people planning a pregnancy or who may become pregnant. However, the researchers caution that longer studies are needed to determine whether the benefits can be sustained. In particular, future research must establish how well participants maintain their weight loss, muscle mass, and diabetes remission after returning to everyday life outside a closely monitored clinical trial. The authors conclude: "By focusing specifically on early-onset type 2 diabetes, our trial addresses a growing clinical population, characterized by elevated cardiovascular disease risk, greater cumulative complication burden, and poor long-term outcomes…In summary, RESET for Remission demonstrated that in early-onset type 2 diabetes, combining structured aerobic and resistance exercise with a low-calorie diet produces high remission rates, induces fat loss while preserving muscle mass, improves muscle quality and function, enhances cardiovascular health, and leads to meaningful improvements in patient-reported outcomes. As the prevalence of early-onset type 2 diabetes rises globally, our findings highlight an opportunity to re-evaluate treatment paradigms and support scalable implementation of integrated dietary and exercise interventions for remission. Our approach may be particularly valuable in those seeking or with potential for pregnancy. It warrants further evaluation in longer term studies in real-world settings." Story Source: Materials provided by European Association for the Study of Diabetes. Note: Content may be edited for style and length. Journal Reference: - Kaberi Dasgupta, Normand G. Boulé, Joseph Henson, Emma Redman, Deborah Chan, Matthew McCarthy, Debora Rosa, Francisko Arsenyadis, Stéphanie Chevalier, Jordan L. Rees, Jihoon Lim, Alex Rowlands, Michelle Hadjiconstantinou, Deborah Da Costa, Edward W. Gregg, Alice Cowley, Matthias G. Friedrich, Carla M. Prado, Mark Sherman, Melanie J. Davies, Elham Rahme, Kamlesh Khunti, Roseanne O. Yeung, Gerry P. McCann, Richard Thompson, Thomas Yates, Kim Arrey, Ryan Kelsey, Nisha Gupta, Carolyn Currie, Henry Tung, Nayna Naliyapara, Christina Weiss, Harvinder Singh, Tricia Peters, Mikila Walters, Salma Rakani, Sam Cook, Alison Doucet, Martha Thomas, Emilie Chan-Thim, Chris Brough, Suneet Atwal, Robert Fraser, Roy Eappen, Ehtasham Ahmad, Mark Roper, Elizabeth Ward, Julia Champagne, Isabel Fortier, Renata Sava, Annick Gauthier, Sola Mansour, Rachel Bond, Michael Tsoukas, Norman Sabin, Vincent Larouche, Jill Pancer, Oriana Hoi Yun Yu, Mark Karanofsky, Jasvir Kaur, Patricia Kearns, Mark Marcinkiewicz, Josette Spencer, Suzanne N. Morin, Melissa-Rosina Pasqua. Low energy diet plus supervised exercise vs. usual care alone in people with early-onset type 2 diabetes (RESET for Remission): a randomised, open-label, blinded-endpoint efficacy trial. The Lancet Regional Health - Americas, 2026; 101664 DOI: 10.1016/j.lana.2026.101664 Cite This Page: