A randomized trial in younger adults with type 2 diabetes found that 54% reached remission after 24 weeks of a low-calorie diet combined with supervised exercise, compared with about 4% of those who received usual care. The results, from the RESET for Remission trial, were published in The Lancet Regional Health – Americas and shared by the European Association for the Study of Diabetes (EASD) on October 30, 2026.
It is an encouraging result, but it comes from a small, closely supervised study that lasted six months. Here is what the researchers did, what they found, and what it does and does not mean.
Key takeaways
- 27 of 50 people (54%) in the diet-plus-exercise group reached remission at 24 weeks, versus 2 of 46 (about 4%) in the usual-care group.
- Participants were adults aged 18 to 45 with early-onset type 2 diabetes and obesity who were not using insulin.
- The program was medically supervised: a very low-calorie diet, medication changes managed by the study team, and coached aerobic and resistance exercise.
- Remission is not a cure. The trial did not test whether the benefit lasts beyond 24 weeks.
Who ran the trial and who took part
RESET for Remission was run at three research centres in England and Canada, linked to the University of Leicester, McGill University in Montreal and the University of Alberta in Edmonton. In total, 96 adults were randomly assigned: 50 to the intervention and 46 to usual care. Their average age was 38 and their average body mass index was 35.2.
The focus on people under 45 is deliberate. Type 2 diabetes diagnosed in early adulthood means more years lived with the condition, which is why researchers are looking closely at what can be done soon after diagnosis.
What the program involved
The intervention had two phases over 24 weeks:
- Weeks 1 to 12: a diet of roughly 800 to 900 calories a day. For the first two weeks all meals were replaced with formula products. After that, participants ate one conventional meal a day alongside protein, fruit and vegetable targets.
- Exercise throughout: supervised aerobic and resistance training twice a week, plus one session on their own each week.
- Weeks 13 to 24: a weight-maintenance diet with continued independent exercise.
Glucose-lowering medications were stopped at the start of the program by the study team, under monitoring. The resistance training was included on purpose: the authors said the study targeted muscle during the intensive weight-loss phase, because rapid weight loss can also reduce muscle.
What the researchers found
Remission was defined as an HbA1c below 6.5% (48 mmol/mol) at 24 weeks with no glucose-lowering medication for at least 12 weeks. That is in line with the definition in the 2021 international consensus report on type 2 diabetes remission.
| Outcome at 24 weeks | Diet plus exercise | Usual care |
|---|---|---|
| Remission | 27 of 50 (54%) | 2 of 46 (about 4%) |
| Average weight change | 100.7 kg to 92.3 kg | 103.2 kg to 102.0 kg |
| At least one side effect reported | 43 of 50 | 6 of 46 |
After adjustment, the intervention group lost 7.5 kg more than the usual-care group, including 6.6 kg more fat. The release also reports improvements in muscle quality, physical performance and cardiovascular health measures. Nine in ten participants (86 of 96) completed the final assessments, and anyone with missing data was counted as not in remission.
Safety and side effects
No severe adverse events were reported. Side effects were much more common in the intervention group, though. Constipation, headache, dizziness and fatigue were typical early on during the restrictive diet phase, and the release says these generally resolved.
The important caveats
- It was short. Twenty-four weeks cannot show whether remission, weight loss or muscle are maintained. The authors say longer studies in real-world settings are needed.
- It was small. Ninety-six people is enough to show a clear difference, but not enough to know how the approach works across different groups.
- It was closely supervised. Participants had coaching, monitoring and medication management that most people do not have access to day to day.
- It was a specific group. The findings apply to adults under 45 with obesity who were not on insulin. They say nothing about type 1 diabetes, and may not carry over to older adults or people with long-standing type 2 diabetes.
- Remission is not a cure. Glucose can rise again, so regular check-ups and screening for complications still matter.
What this means for you
Please do not try a very low-calorie diet or stop any medication on your own. In this trial, both were done under medical supervision. Cutting calories sharply while taking glucose-lowering medication, especially insulin or a sulfonylurea, can cause low blood sugar, and stopping medication without a plan can send glucose high.
If remission interests you, ask your doctor or diabetes care team whether a supervised weight-management program is available and suitable for you. The trial also adds to a wider message that applies to almost everyone: combining healthy eating with both aerobic and strength training supports glucose, fitness and muscle, whether or not remission is the goal. Our overview of why moving matters with diabetes covers the basics, and the latest ADA/EASD type 2 consensus explains how weight management fits into care.
If you are building an activity habit, the DiaFitus app can help you plan workouts and check your glucose before you start. It is a wellness tool, not a remission program, and it does not replace your care team.
The bottom line
RESET for Remission suggests that, for some younger adults with type 2 diabetes, a supervised low-calorie diet paired with structured exercise may bring glucose back below the diabetes threshold within six months. Whether that lasts is the question the next studies need to answer.
