Intensive diet and exercise program may put type 2 diabetes into remission

More than half of younger adults taking part in an intensive diet and exercise program achieved remission from type 2 diabetes within six months, according to a small trial that compared the structured plan with standard medical care.

The results may offer encouragement for people who develop diabetes early in adulthood, when the disease can create many years of health risks. They also point to the potential value of pairing weight loss with exercise to improve blood sugar control while maintaining fitness.

The RESET for Remission trial involved 96 adults aged 18 to 45 with type 2 diabetes and obesity who were not using insulin. The study, led by researchers at McGill University and the University of Leicester, was published in The Lancet Regional Health – Americas.

Participants were randomly assigned to either usual care or a 24-week program built around a low-energy diet and structured exercise. Fifty people entered the intensive program, while 46 received usual care, enabling direct comparison of outcomes.

The diet portion was medically supervised and began with meal-replacement products that supplied about 800 to 900 calories a day. Conventional foods were then reintroduced gradually, followed by a maintenance phase designed to help sustain the progress participants had made.

The exercise component combined supervised aerobic and resistance training with independent activity. The goal was to build fitness and preserve strength during weight loss, rather than focusing only on the number on the scale.

By the end of the trial period, 27 of the 50 people in the program had reached remission, compared with two of the 46 in the usual-care group. That equals 54% in the intensive group and about 4% in the comparison group.

Remission meant average blood sugar, measured by the HbA1c test, stayed below the diabetes threshold without glucose-lowering medication for at least 12 weeks. It does not mean diabetes has been permanently cured or cannot return.

Among participants with available weight data, average weight loss was about 8.4 kilograms in the program group and 1.2 kilograms in the usual-care group. Those changes lined up with the blood sugar improvements, although the trial could not isolate the separate effects of diet and exercise.

The intensive program also produced more reported side effects, including constipation, headache, dizziness and fatigue. Most of these problems resolved, and no severe adverse events were reported, but the findings highlight the difference between supervised treatment and an ordinary diet plan.

The trial was small and lasted only six months. Longer follow-up will be needed to see how many people can maintain remission, weight loss and improved physical fitness after the structured support ends.

Even with those limitations, the contrast between the two groups is promising. The study suggests that an intensive, supported approach can help some people with early-onset type 2 diabetes reach remission, making further long-term testing an important next step.

Source: McGill University and University of Leicester.

Read the research: Journal article