An intensive programme combining a very low-calorie diet with supervised exercise was associated with Type 2 diabetes remission in more than half of younger adults taking part in a new trial.
The RESET for Remission study involved 96 adults aged between 18 and 45 who were living with obesity and early-onset Type 2 diabetes. Researchers from McGill University in Canada and the University of Leicester carried out the work, which was published in The Lancet Regional Health – Americas.
Among those who completed the lifestyle intervention, 54% achieved remission within 24 weeks. This compared with 4% of participants who received standard medical care, meaning people in the intensive programme were reported to be 21 times more likely to reach remission. None of the participants was using insulin.
What the programme involved
The intervention was deliberately structured and closely monitored rather than presented as a simple diet plan. For the first two weeks, participants consumed meal-replacement products as part of a daily intake of between 800 and 900 calories. From the third to the 12th week, they introduced one planned meal each day, based on lean protein and vegetables.
The final 12 weeks concentrated on maintaining weight loss. Alongside the dietary changes, participants completed supervised aerobic and resistance exercise, as well as one additional workout independently each week. Blood sugar and blood pressure medicines were stopped under medical supervision during the intervention.
That medical oversight is an important part of the findings. The calorie target was highly restrictive, and the study did not test whether people could safely reproduce the programme without professional support. Its results therefore describe a specific clinical intervention, rather than a recommendation for people to attempt rapid weight loss on their own.
Protecting muscle during weight loss
The researchers also focused on a concern linked with losing weight quickly: whether reductions in body weight might include the loss of muscle. Resistance training was included to help participants retain lean tissue while reducing body fat.
MRI scans indicated that participants’ muscle mass did not fall during the programme, while handgrip strength improved. They also recorded better treadmill endurance. Participants lost an average of 18.5 pounds over 24 weeks, according to the study report.
“In our study, we think the diet provoked the weight loss, and exercise helped make sure it was [not] from muscle,” lead researcher Dr Kaberi Dasgupta said.
Dr Dasgupta, a professor of medicine at McGill University, said the research demonstrated that substantial dietary change could be combined with supervised exercise. The findings suggest that the exercise element may have served a practical purpose beyond general fitness, helping to support strength while participants lost weight.
What the results mean for readers
The headline remission figure is significant, but it applies to a defined group: younger adults with obesity and early-onset Type 2 diabetes who were not using insulin and who completed an intensive programme. The study does not establish that the same outcome would apply to every person with the condition.
For anyone considering major changes to food intake, exercise or medication, the clearest message is the need for support from a qualified healthcare professional. In this trial, medicines were withdrawn only with medical supervision, and the food and exercise plan was delivered in a structured setting.
The study nevertheless adds to the evidence that lifestyle interventions can be an important part of diabetes care. It also places weight management, physical activity and preservation of muscle in the same conversation, rather than treating them as separate goals. For patients and clinicians, the results offer a basis for discussing whether a closely supervised programme may be suitable for some younger adults with early-onset disease.
| Trial measure | Intensive programme | Routine care |
|---|---|---|
| Participants reaching remission | 54% | 4% |
| Reported average weight loss | 18.5 pounds over 24 weeks |
