More than half of participants following a structured diet and exercise program achieved type 2 diabetes remission after six months.
The study compared an intensive lifestyle intervention with standard medical care and found a significant difference in outcomes.
Researchers say the approach shows promise, but longer-term studies are needed to determine whether remission and weight loss can be maintained.
Managing type 2 diabetes often involves a combination of medication, dietary changes, and physical activity. But new research suggests that a more structured approach to weight loss and exercise could help some younger adults achieve something even more significant: diabetes remission.
The study, published in The Lancet Regional Health – Americas, focused on adults diagnosed with type 2 diabetes before age 45. This group can face a particularly challenging course of the disease, including faster declines in blood sugar control and an increased risk of developing complications earlier in life.
Researchers wanted to see whether combining a low-calorie diet with supervised exercise could help more people achieve remission than standard medical care alone.
Importantly, remission doesn't necessarily mean diabetes has been permanently cured. It means blood sugar levels have dropped below the diagnostic threshold without the use of glucose-lowering medication.
How the researchers tested the approach
The randomized clinical trial, called RESET for Remission, included 96 adults between the ages of 18 and 45 with obesity and early-onset type 2 diabetes. Participants were recruited at three research centers in England and Canada.
Researchers divided participants into two groups. One continued with standard medical care, while the other followed an intensive 24-week lifestyle program.
During the first 12 weeks, participants in the intervention group consumed just 800 to 900 calories daily. They also completed supervised aerobic and resistance training twice a week, along with one independent workout each week.
For the first two weeks, participants replaced all meals with specially formulated nutritional products. They gradually reintroduced regular food while maintaining their calorie targets during the following 10 weeks.
For the final 12 weeks, participants transitioned to a diet designed to maintain their weight loss and continued exercising independently.
Researchers then measured how many participants achieved remission. To qualify, participants needed an HbA1c level below 6.5% and had to remain off glucose-lowering medication for at least 12 weeks. HbA1c is a blood test that measures average blood sugar levels over approximately three months.
What the findings mean for consumers
The results showed a considerable difference between the two groups. After 24 weeks, 27 of the 50 participants following the intensive program achieved remission, compared with just two of the 46 receiving standard care.
Participants in the intervention group also lost an average of 8.4 kilograms (about 18.5 pounds), compared with 1.2 kilograms (about 2.6 pounds) in the standard-care group.
Researchers were particularly interested in how resistance training helped participants preserve muscle while losing weight. The findings suggest that combining exercise with calorie restriction can help people lose body fat without sacrificing as much muscle mass.
There were some drawbacks, however. Side effects were more common among participants following the intensive program, with constipation, headaches, dizziness, and fatigue among the reported complaints. No serious adverse events occurred.
The researchers also emphasized that more work is needed to understand whether participants can maintain their weight loss and diabetes remission over time.
For consumers, the findings offer encouraging evidence that structured dietary changes and exercise could play an important role in managing early-onset type 2 diabetes. However, the program was intensive and medically supervised, so its calorie restrictions and medication changes should not be attempted without medical guidance.