A rigorous program integrating a low-calorie diet with supervised strength and aerobic training enabled more than half of younger adults to achieve remission from type 2 diabetes within six months, according to a study published in The Lancet Regional Health - Americas.
The RESET for Remission trial found that 54% of participants under age 45 who completed the intensive lifestyle intervention achieved disease remission. In contrast, only 4% of participants receiving standard medical care reached the same milestone.
Type 2 diabetes diagnosed at a younger age is often more aggressive, leading to faster loss of blood sugar control, earlier cardiovascular complications, and a shorter life expectancy compared to later diagnoses. Researchers from McGill University and the University of Leicester enrolled 96 adults aged 18 to 45 who had early-onset type 2 diabetes and were living with obesity, none of whom were using insulin.
Participants in the intervention group halted their blood sugar and blood pressure medications under medical supervision. They began an intensive 800- to 900-calorie daily diet, initially consisting of meal-replacement products for two weeks. This was followed by 12 weeks where one structured meal of lean protein and vegetables was allowed alongside meal replacements, before moving into a 12-week weight maintenance phase.
The program also included supervised aerobic and resistance training twice weekly, with an additional solo workout each week. The researchers emphasized resistance training to mitigate the loss of lean muscle mass, a significant risk associated with rapid weight loss.
"Our study shows that it is possible to combine a low-calorie diet with supervised exercise in young adults with type 2 diabetes," stated lead author Dr. Kaberi Dasgupta, a professor at McGill University. "There has previously been some concern about combining the two as being too much of a burden for people. However, people in our study stayed in our study."
Only 10% of participants did not complete the final evaluations, and attendees participated in a median of 17 out of 20 scheduled supervised gym sessions. According to the study, participants shed an average of 18.5 pounds over 24 weeks, while also improving treadmill endurance and cardiovascular fitness.
To meet the medical standard for remission, patients needed to maintain blood sugar levels below an HbA1c of 6.5% for at least 12 weeks while completely off diabetes medication. After accounting for baseline health factors, the study concluded that individuals on the diet and exercise program were 21 times more likely to achieve remission than those receiving routine care.
However, the study noted limitations, including its small sample size of fewer than 100 individuals and a relatively short six-month duration. Researchers also could not definitively isolate the specific benefits of diet versus exercise. "The main limitation is that we had to compare the diet plus exercise with usual care," Dr. Dasgupta explained. "We would have liked to compare diet alone against diet and exercise to perfectly prove the point that the improvements in muscle and fitness were from the exercise."
Additionally, the regimen posed a physical challenge, with approximately 86% of the intervention group reporting mild to moderate side effects such as headaches, fatigue, dizziness, and constipation during the initial weeks, though no severe medical complications occurred. Health professionals cautioned that diabetes remission is not a permanent cure, and maintaining such a strict regimen outside a clinical setting can be difficult. Longer-term studies are needed to assess sustained weight loss, muscle maintenance, and medication-free status in real-world conditions.