Type 2 diabetes diagnosed before the age of 45 can be particularly challenging because blood sugar control may deteriorate over time, increasing the risk of long-term complications.

New research suggests that combining a carefully supervised low-calorie eating plan with structured physical activity may help some younger people achieve diabetes remission.

What the Study Discovered

The RESET for Remission trial included 96 participants aged 18 to 45 from research centers in England and Canada. Participants received either usual diabetes care or an intensive program combining dietary restriction with planned exercise. After 24 weeks, 27 of the 50 participants in the intervention group achieved remission, representing 54%. In comparison, remission occurred in two of the 46 participants receiving usual care, or approximately 4%.

For the trial, remission meant that participants had an HbA1c level below the diagnostic threshold for diabetes and had not used glucose-lowering medication for at least 12 weeks. HbA1c is a blood test that reflects average glucose levels over approximately two to three months.

The findings are notable because type 2 diabetes diagnosed at a younger age can progress quickly. However, remission does not mean the condition has been permanently eliminated. Blood glucose can rise again, making ongoing monitoring and continued medical support important.

How the Diet and Exercise Program Worked

During the first 12 weeks, participants followed a low-energy eating plan providing approximately 800 to 900 calories daily. The initial two weeks relied on meal-replacement products, followed by a phase that incorporated selected regular foods, including protein sources, fruit, and non-starchy vegetables.

The exercise component included supervised aerobic and resistance sessions twice weekly, alongside independent activity. Aerobic exercise supports endurance and cardiovascular fitness, while resistance training helps maintain muscle strength and physical function during substantial dietary restriction.

For the next 12 weeks, participants transitioned toward a weight-maintenance eating plan and continued exercising. This phase was important because maintaining progress after an intensive intervention can be difficult. The program was not simply about reducing food intake. It combined dietary management, physical conditioning, and professional oversight to address several aspects of metabolic health at the same time.

Benefits Beyond Blood Sugar Control

Participants in the combined intervention experienced greater weight reduction than those receiving usual care. Researchers also reported improvements in physical fitness, muscle quality, and measures of cardiovascular health. Maintaining muscle during substantial weight reduction is important because muscle supports mobility, strength, and the body's use of glucose. Resistance training may help preserve physical function while daily energy intake is reduced.

Expert Insight

Professor Juleen Zierath, a professor of physiology at Karolinska Institutet in Sweden, commented on the findings in Medscape Medical News: “these findings are important because early-onset type 2 diabetes is a growing group with an aggressive disease course, and it has been underrepresented in trials.”

Safety and Important Limitations

Although no severe adverse events were reported, many participants receiving the intervention experienced at least one side effect. Common problems included constipation, headaches, dizziness, and tiredness, particularly during the early dietary phase. The trial also involved a relatively small group, and the intervention was intensive. Its findings therefore cannot automatically be applied to everyone with type 2 diabetes, particularly people using insulin or those with other medical needs who were not represented in the study.

An intake of 800 to 900 calories per day is highly restrictive and should not be attempted without professional supervision. Anyone considering substantial dietary changes should consult a qualified healthcare professional. Diabetes medication should never be stopped or adjusted without appropriate medical guidance.

The study supports further development of medically supervised lifestyle programs, but it does not establish a permanent cure or guarantee the same outcome for everyone. Continued monitoring, individualized treatment, and research into long-term results remain essential.