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In the randomized RESET for Remission trial, 54% of young adults with early-onset type 2 diabetes in a low-calorie diet and exercise program met the study’s remission definition at 24 weeks, compared with 4% receiving usual care. Researchers reported no serious adverse events, but the trial was small and does not establish how long remission lasts or how much benefit came specifically from exercise.
A structured low-calorie diet and exercise program was associated with remission of early-onset type 2 diabetes in 54% of participants at 24 weeks, compared with 4% receiving usual clinical care, according to the randomized RESET for Remission trial. The result matters because the program was tested in adults diagnosed before age 45, a group researchers say faces risks from diabetes complications earlier in life.
The trial randomized 96 adults ages 18 to 45 to the intervention or usual care. Participants had been diagnosed within the prior six years. Remission meant an HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks. The adjusted odds ratio for remission was 21.6, with a 95% confidence interval of 6.2 to 114.5; the wide interval reflects uncertainty around the estimate.
For the first 12 weeks, the intervention used 800 to 900 calories a day from meal replacements, twice-weekly supervised aerobic and resistance exercise, and one independent exercise session each week. A 12-week maintenance phase followed, with a nutritionally optimized diet, fewer meal replacements and independent exercise. About 90% completed the final assessment. Researchers counted participants who did not complete the study as not having achieved remission.
At baseline, 74% of participants were taking metformin, 20% an SGLT2 inhibitor and a small minority a GLP-1 drug. The study was open-label, meaning participants and researchers knew which treatment participants received. No serious adverse events were reported. Common effects included temporary headaches, constipation, dizziness and fatigue when starting the diet; mild infections were slightly more frequent in the intervention group.
Remission in Younger Adults
Early-onset type 2 diabetes can mean more years living with the condition and exposure to its complications. Study presenter Kaberi Dasgupta of McGill University said those complications can arise as people start families, relationships and careers. The trial suggests a structured diet-and-exercise program may help some younger adults reach a medication-free remission measure over the period studied.
Participants in the intervention also had reported improvements in blood pressure, triglycerides, strength and quality of life, among other measures. More reached hypertension remission than in usual care, 56% versus 27%. These are trial findings, not a guarantee that an individual will achieve the same results, and the study did not establish that remission will continue after follow-up ends.
The intervention produced less total weight loss than the comparison with tirzepatide cited by co-investigator Thomas Yates: 16.5 pounds at 24 weeks in RESET versus 28.4 pounds at 52 weeks in SURPASS-3. Those figures come from different trials and time periods, so they do not provide a direct head-to-head comparison. Yates said body composition and changes in visceral and liver fat may also matter when evaluating exercise-related metabolic effects.
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How the Program Was Tested
Earlier studies had found that low-energy meal replacement diets can help produce diabetes remission without surgery. Researchers said fewer studies had assessed such diets alongside structured, supervised exercise. RESET tested the combined program against routine clinical care, so its results show how the package performed; they do not isolate the contribution of exercise from the diet.
The study focused on early-onset diabetes, defined as diagnosis before age 45. Participants’ average age was 38, and average baseline HbA1c was 7.2%. Remission rates were reported as consistent across subgroup analyses by sex, ethnicity and country, though the 96-person sample limits how firmly subgroup results can be interpreted.
“It’s already quite a lot to ask someone to adhere to a meal-replacement diet. Adding supervised exercise makes it even more challenging.”
— Kaberi Dasgupta, MD, MSc, McGill University
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Duration and Exercise Effects
The results cover 24 weeks; the report does not establish whether participants remained in remission beyond that point or how often remission later ended. The trial compared the combined program with usual care, not diet alone with diet plus exercise, leaving the added effect of exercise uncertain. With 96 participants, the estimates and subgroup findings also need confirmation in larger studies.
The reported weight-loss comparison with tirzepatide came from a separate trial with a different follow-up period, rather than a direct comparison. The source report does not provide enough information to determine whether the program would produce similar adherence, remission rates or safety outcomes in broader patient groups.
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Further Trials and Longer Follow-Up
Researchers say further research is needed to confirm the added benefit of exercise and to clarify how durable remission is after the program’s maintenance phase. Longer follow-up could show whether participants sustain changes in blood sugar, medication use and body composition, and whether the program’s demands are manageable outside a trial.
For now, the findings provide a 24-week result for a defined group of younger adults. They do not establish a universal approach to diabetes care; treatment decisions remain individual and should be discussed with a qualified health professional.
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Key Questions
What did the trial count as diabetes remission?
It was defined as HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks.
How many participants reached remission?
At 24 weeks, 54% in the intervention group met the remission definition, compared with 4% receiving usual care. The trial included 96 participants overall.
What did the intervention involve?
It included 12 weeks of an 800-to-900-calorie daily meal-replacement diet, supervised exercise twice a week and independent exercise once a week, followed by a 12-week maintenance phase.
Does the trial show that exercise caused the remission?
No. The intervention combined diet and exercise and was compared with usual care. It did not isolate exercise’s contribution; the researchers said further studies are needed to confirm its added benefit.
Are the results known to last beyond 24 weeks?
The report gives outcomes at 24 weeks and does not establish how long remission lasts after that assessment.
Source: rss
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