- A new trial found that 54% of adults with early onset type 2 diabetes (diagnosed before age 45) entered remission after 6 months on a supervised low calorie diet and exercise program, compared with only 4% who received usual care.
- The intervention combined an 800- to 900-calorie-per-day diet with twice-weekly supervised exercise for 12 weeks, followed by a weight-maintenance phase.
- Participants were closely supervised by physicians and licensed dietitians throughout the 24-week program.
The RESET for Remission trial, presented at the 2026 European Association for the Study of Diabetes (EASD) Annual Meeting and published in The Lancet Regional Health Americas on October 1, found that more than half of adults with early onset type 2 diabetes entered remission after six months on a low calorie diet and supervised exercise program.
Early onset type 2 diabetes is when the condition is diagnosed before age 45.
Those with early onset type 2 diabetes may be at a higher risk of complications like long-term damage to the capillaries (microvascular complications), adverse cardiovascular outcomes, and earlier death.
Typical treatment for early onset type 2 diabetes is often a combination of lifestyle changes, like diet and exercise, and medications.
However, this new study suggests that a supervised low calorie diet and exercise program may help some people with early onset type 2 diabetes enter remission.
Diet and exercise led to type 2 diabetes remission
The RESET for Remission trial included 96 adults from England and Canada who were between the ages of 18 and 45, had early onset type 2 diabetes, obesity, and were not on insulin treatment.
The participants had an average age of 38 and an average body mass index (BMI) of 35.2 kg/m2. They were randomized into a control group that received usual care alone and the intervention group, which ate a low calorie diet and participated in supervised exercise programs.
During the first 12 weeks, participants in the intervention group followed an 800–900-calorie-per-day diet and completed twice-weekly supervised aerobic and resistance exercise sessions, along with one independent exercise session per week.
For weeks 13–24, they transitioned to a weight-maintenance diet and independent exercise.
Both groups were supervised by physicians, and the intervention group was also closely supervised by licensed dietitians.
The low calorie diet consisted of 30% protein, 50% carbohydrate, and 20% fat. Participants were also encouraged to drink at least 2 liters of calorie-free fluids per day and given access to a fiber-based laxative as needed.
In the first two weeks, all meals were replaced with specially formulated nutritional products (Optifast). Then, in weeks 3–12, the participants maintained the same calorie intake but had more flexibility in their food choices.
This second phase of the diet included one conventional meal per day, with daily intake targets that included protein, fruit, and vegetables. Typically, this meant 60 to 90 grams of protein from all sources combined, one portion of fruit, and two portions of non-starchy vegetables.
At the end of 24 weeks, 54% of the intervention group entered remission of type 2 diabetes, compared with only 4% in the control group. Researchers defined remission as an HbA1c level below 6.5% without glucose-lowering medication for at least 12 weeks.
“This study proves what most physicians have advocated for quite some time. Clearly, diet and exercise can work to improve or even resolve diabetes,” David Cutler, MD, board certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, who wasn’t involved in the study, told Healthline.
Study limitations
Cutler also added that this study provides a clear example of how difficult it can be to enter diabetes remission with diet and exercise alone. He stated that the small number of participants in the study also makes him wonder if these findings can be applied to all populations.
Another limitation of this study, as Cutler pointed out, was that the strict dietary limits imposed on study participants would be very difficult for the average adult to adhere to.
The study also followed participants for only six months, so it’s unclear how many would remain in remission over the longer term.
“It is worth trying diet and exercise first because they can work to achieve meaningful weight loss and remission of diabetes,” he said.
Preventing or delaying type 2 diabetes
It may be possible to prevent or delay the onset of type 2 diabetes by:
- maintaining a moderate weight or losing weight if you are living with overweight or obesity
- participating in regular physical activity, at least 30 minutes a day, 5 days a week
- eating a healthy and balanced diet
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that losing 5%–7% of your body weight can help reduce your risk of type 2 diabetes.
Why early onset type 2 diabetes can be especially dangerous
Early onset type 2 diabetes is a growing issue worldwide, coinciding with the rise of obesity.
Research from the Centers for Disease Control and Prevention (CDC) projects that the number of people in the United States under age 20 with type 2 diabetes could reach 220,000 by 2060. This is an increase of 700%.
People diagnosed with type 2 diabetes at a younger age face more decades of living with the condition, along with a higher risk of developing complications earlier in life and reduced life expectancy. These complications can develop as early as midlife and include:
Speak with a healthcare professional about your risk of type 2 diabetes and changes you might be able to make in order to prevent or delay diagnosis.
A later diagnosis can help reduce the risk of some complications of the condition.
Low-Calorie Diet and Supervised Exercise May Reverse Early Onset Type 2 Diabetes
Source: Pinoy Lang Sakalam
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