Over half of young adults with type 2 diabetes reached remission in a six-month diet and exercise trial

More than half of young adults with type 2 diabetes who followed a six-month program of a low-calorie diet and supervised exercise went into remission, the McGill University Health Centre (MUHC) said on 26 October. In the RESET for Remission trial, 54% of participants on the program reached remission, against 4% of those who received usual care.

96 young adults in three cities

The trial included 96 adults aged 18 to 45 with type 2 diabetes and obesity in Montreal and Edmonton in Canada and Leicester in the UK. Fifty were randomly assigned to the program and 46 to usual care. It was led by Dr. Kaberi Dasgupta of the Research Institute of the MUHC and Professor Tom Yates of the University of Leicester, and published in The Lancet Regional Health – Americas.

Twelve weeks of shakes and exercise, then maintenance

For the first 12 weeks, participants ate 800 to 900 calories a day, mostly from meal-replacement shakes and bars, and did aerobic and strength training twice a week with supervision and once a week on their own. For the next 12 weeks they switched to a healthy, food-based diet aimed at keeping the weight off, and kept exercising on their own.

Remission was defined as blood sugar below the level used to diagnose diabetes, without any diabetes medication, for at least 12 weeks. By that measure, 27 of 50 people in the program reached remission, against 2 of 46 in usual care. Those in the program lost on average about 7.5 kg more than the comparison group, including more than 9% of their liver fat and more than 24% of the fat around their organs, measured by MRI, while muscle was largely preserved.

Fitness rose by about 10% relative to body weight, grip strength improved, and blood pressure and resting heart rate fell. Participants also reported fewer depressive symptoms, less diabetes-related distress and better quality of life. Side effects such as constipation, headache, dizziness and fatigue were temporary, and there were no serious adverse events.

“Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise” with a low-energy diet. — RESET for Remission researchers

What it means for patients now

The program combines tools that already exist: meal-replacement diets and supervised exercise. It is not a new drug; it was tested under trial conditions, with supervised exercise sessions and a structured meal-replacement plan. The trial had no diet-only group, so it cannot yet show whether the exercise is what preserved muscle and improved fitness, and the remission rates are at the upper end of similar studies. The team now plans a larger, longer study comparing diet alone with diet plus exercise in real-world settings. The phases a treatment goes through are collected on our clinical trial hub.