Type 2 diabetes remission just got a lot more real for younger patients. More than half of the young adults who tried a strict low-calorie diet plus a structured workout plan got their type 2 diabetes below the diagnostic line within six months, with no glucose-lowering drugs at all. In the usual-care group, only 2 out of 46 people did the same.
The results come from the RESET for Remission trial, presented this week at the European Association for the Study of Diabetes (EASD) annual meeting in Milan and published in The Lancet Regional Health – Americas. It is one of the strongest signals yet that type 2 diabetes remission is a realistic goal for people diagnosed young. Here’s what the study did, what it found, and why you should not try the diet on your own.
What the Type 2 Diabetes Remission Trial Found
The headline number: 27 of 50 people (54%) in the diet-and-exercise group were in remission at 24 weeks, compared with 2 of 46 (4%) in the usual-care group. After statistical adjustment, people in the intervention group were about 21 times more likely to reach remission, according to the EASD summary of the study.
The trial was led by Professor Kaberi Dasgupta of McGill University in Montreal and Professor Thomas Yates of the University of Leicester in the UK, with colleagues at the University of Alberta in Edmonton.
Other key results at 24 weeks:
- Weight: The intervention group lost an average of 8.4 kg (about 18.5 pounds), versus 1.2 kg in the control group.
- Fat, not muscle: After adjustment, the intervention group lost 7.5 kg more than controls, including 6.6 kg more fat mass. Researchers reported that fat-free mass and muscle volume were preserved.
- Strength and fitness: The intervention group showed greater handgrip strength and better fitness relative to body weight.
The authors wrote that their remission rates “are at the upper end of those previously reported in the literature for trials of similar duration.”
What “Remission” Actually Means
Type 2 diabetes remission is not the same as a cure. In this trial, remission meant an HbA1c (a three-month average of blood sugar) below 6.5%, or 48 mmol/mol, while off all glucose-lowering medication for at least 12 weeks.
That 6.5% figure is the threshold used to diagnose diabetes. So people in remission had blood sugar back under the diabetes line without pills or injections. But the underlying tendency doesn’t disappear. If weight comes back, blood sugar can climb again, which is why doctors keep monitoring people in remission.
Who Was in the Study
The trial tested type 2 diabetes remission in a group doctors are increasingly worried about: people with early-onset type 2 diabetes. Participants were:
- Adults ages 18 to 45 (average age 38)
- Living with obesity (average BMI 35.2)
- Not on insulin
- Within six years of their diagnosis, according to the published trial protocol
In total, 96 people were randomized between September 2021 and June 2025 at three centers: 40 in the UK and 56 in Canada. Ninety percent (86 people) attended the final assessments. People who missed follow-up were counted as not in remission, a conservative approach that avoids inflating the results.
The Diet and Exercise Plan, Step by Step
This was not a “cut back a little” plan. It was an intensive, medically supervised program in two phases.
Weeks 1-12: The Intensive Phase
- 800-900 calories a day. The first two weeks were total meal replacement using formula products (shakes and similar). From weeks 3 to 12, participants kept the same calorie level but could eat one food-based meal a day.
- Macros: Roughly 30% protein, 50% carbohydrate and 20% fat, with at least 2 liters of calorie-free fluid daily.
- Medication changes: Participants stopped glucose-lowering and blood pressure medicines when the diet began, under the study team’s supervision (blood pressure drugs were kept for people with kidney protein in the urine).
- Exercise: Twice-weekly supervised sessions mixing aerobic and resistance training, plus one independent session each week.
Weeks 13-24: The Maintenance Phase
Participants moved to a weight-maintenance diet and kept exercising on their own. The goal was to hold on to the weight loss and fitness gains.
The resistance training is the twist. Rapid weight loss from dieting alone usually strips away some muscle along with fat. The researchers wrote that targeting muscle with strength work showed “fat-free mass and muscle preservation is achievable with rapid weight loss.”
Why Early-Onset Type 2 Diabetes Is a Big Deal
Type 2 diabetes used to be thought of as a disease of middle and older age. That’s changing. The researchers describe early-onset type 2 diabetes as “a distinct and growing clinical phenotype” with rapid deterioration in blood sugar control, early complications, and lower life expectancy than later-onset disease.
The trial’s protocol paper notes that diabetes diagnosed before age 40 carries a magnified lifetime risk of cardiovascular disease. Put simply: the earlier it starts, the more years it has to damage the heart, kidneys, eyes and nerves.
That’s why the authors argue this group merits “a potent intervention” early on, rather than a slow, step-by-step approach. They also noted their approach “may be particularly valuable in those seeking or with potential for pregnancy.”
How This Fits With Earlier Type 2 Diabetes Remission Research
RESET for Remission builds on the landmark DiRECT trial in the UK, led by Professor Roy Taylor and Professor Michael Lean and published in The Lancet in 2018. In DiRECT, 46% of people on a primary care-led program of total diet replacement (about 825-853 calories a day for three to five months) were in remission at one year.
DiRECT also showed that the amount of weight lost mattered. Among participants who lost 15 kg or more, 86% reached remission.
What’s new here is the focus on younger adults, a multi-ethnic population across two countries, and the built-in supervised exercise. The authors say this is the first time such results have been shown in “a multi-ethnic population with early onset type 2 diabetes through a combined low energy diet and structured exercise intervention.”
Where GLP-1 Drugs Come In
Many people now hear about blood sugar and weight mainly through GLP-1 medications like semaglutide and tirzepatide. These drugs are powerful tools, but they don’t work the same for everyone, as a recent genetic study on GLP-1 response showed. A structured diet-and-exercise route gives doctors and patients another evidence-based option, and the two are not mutually exclusive. Which path to type 2 diabetes remission or better control fits you is a conversation for your care team.
The Caveats: Read These Before You Get Excited
This is encouraging research, but it has clear limits:
- It’s short. Results are at 24 weeks. We don’t yet know how many people stayed in remission at one, two or five years. The authors say longer studies in real-world settings are needed.
- It’s small. 96 people is a modest trial, and it focused on adults 18-45 with obesity.
- It was open-label. Participants knew which group they were in, though the outcome assessment was blinded.
- Side effects were common. 43 of 50 people in the intervention group reported at least one adverse event (vs. 6 of 46 controls), mostly early diet effects like constipation, headache, dizziness and fatigue that resolved. There were no severe adverse events.
- Weight regain is the norm. The researchers themselves point out that most people regain some or all of the weight after any weight-loss program, which is why maintenance support matters.
Thinking About Type 2 Diabetes Remission? What to Do Next
If you were diagnosed with type 2 diabetes in your 20s, 30s or early 40s, this study is a good reason to have a fresh conversation with your doctor. Here’s how to approach it:
- Don’t start an 800-calorie diet on your own. In this trial, medications were stopped and adjusted by the study team. Cutting calories this hard while still on diabetes or blood pressure drugs can cause blood sugar or blood pressure to drop too low.
- Ask about remission directly. Questions to bring: “Am I a candidate for a remission-focused program?” “Is there a supervised low-calorie or total diet replacement program near me?”
- Add strength training. Even outside a trial, resistance exercise helps protect muscle while you lose weight. Start where you are and build up with guidance.
- Plan for maintenance. The hardest part is keeping weight off. Steady habits matter, including daily movement, fiber-rich foods like whole grains, and good sleep. Regular workouts can help there too, as our look at exercise for better sleep found.
- Keep your checkups. Even in remission, keep getting your HbA1c, eyes, kidneys and feet checked as your doctor recommends.
The Bottom Line
For younger adults with type 2 diabetes and obesity, a supervised 12-week low-calorie diet paired with aerobic and strength training put 54% into remission at six months, while preserving muscle. That’s a big deal for a group facing decades of potential complications.
But this was a short, small study, and the program was run by medical teams. Type 2 diabetes remission is possible for many people, and the safest way to chase it is with your doctor in your corner.
This article is for general information and isn’t medical advice. Talk to your doctor before changing your diet, exercise routine or medications. Stay tuned to USA One News for more on the latest health research.
