A Structured Diet and Exercise Program Helped Younger Adults Reach Diabetes Remission
In a 24 week trial of adults aged 18 to 45 with early-onset type 2 diabetes, a supervised program pairing a low-calorie diet with cardio and strength training led to remission in 54% of participants, compared with 4% in usual care.
Have you heard? In a new randomized trial, more than half of younger adults with recently diagnosed type 2 diabetes reached remission after 24 weeks of a closely supervised program that combined a low-calorie diet with aerobic and resistance training.
The study, called RESET for Remission, was published in October 2026 in The Lancet Regional Health (Americas) by researchers in England and Canada. November is National Diabetes Month, which makes this a good time to look at what the research showed, and what it did not.
This study also treated muscle as part of the plan. It built supervised strength and cardio sessions into the program and measured what happened to fitness, strength, and muscle.
27 of 50 participants
2 of 46 participants
Remission in this study meant an HbA1c below 6.5% with no glucose-lowering medication for at least the previous 12 weeks.
01 / The studyWhat researchers tested
The trial enrolled 96 adults aged 18 to 45 at centers in Leicester, Montreal, and Edmonton. All had been diagnosed with type 2 diabetes within the previous six years, were living with obesity, and were not using insulin. The average age was 38.
Participants were randomly assigned to one of two groups. The usual care group (46 people) kept receiving routine care from their own providers. The intervention group (50 people) followed a 24 week program in two phases:
| Phase | Nutrition | Training |
|---|---|---|
| Weeks 1 to 12 | About 800 to 900 calories a day. Full meal replacement for the first two weeks, then meal replacements plus one food-based meal daily, with coaching from study doctors and dietitians. | Two sessions a week supervised by exercise physiologists, building to one hour each, split evenly between aerobic work (mostly walking) and resistance training for the major muscle groups. Plus one independent aerobic session each week. |
| Weeks 13 to 24 | Meal replacements tapered off and replaced by a weight maintenance eating plan, with dietitian support. | Exercise continued independently at a gym or at home, following a prescription matched to the supervised program, with coaching check-ins. |
When the diet began, the intervention group stopped glucose-lowering medication, and blood pressure medication unless it was needed to protect the kidneys, under the supervision of study physicians, who monitored glucose and blood pressure and restarted medication when clinically needed.
02 / The resultsWhat they found
At 24 weeks, 27 of 50 intervention participants (54%) were in remission, compared with 2 of 46 in usual care (about 4%). At the 12 week mark, the figures were 29 of 50 (58%) and 2 of 46.
Weight and fat
The intervention group lost about 7.5 kg (roughly 16.5 lb) more than usual care, and most of that loss was fat.
Muscle
Changes in fat-free mass and MRI-measured muscle volume did not differ from usual care, so muscle was preserved despite the weight loss.
Fitness and strength
Fitness relative to body weight improved about 10% and grip strength about 8% more than in usual care.
Other markers
HbA1c, blood pressure, resting heart rate, triglycerides, and liver fat also improved more in the intervention group.
Side effects were common. Forty-three of 50 intervention participants reported at least one adverse event, compared with 6 of 46 in usual care, mostly temporary early-diet symptoms such as constipation, headache, dizziness, and fatigue. No serious adverse events were reported.
03 / Our focusWhy muscle matters
Skeletal muscle is the main tissue that takes up glucose from the blood in response to insulin. When people cut calories sharply, they tend to lose some muscle along with fat, and this has been seen in people with type 2 diabetes too. Researchers have raised concerns that losing muscle during medically supported weight loss could affect strength, physical function, and metabolic health.
Despite substantial fat loss, participants in the program kept their muscle volume, had less fat stored in and between their thigh muscles, gained grip strength, and improved their fitness.
That is encouraging. Still, because there was no diet-only group, the study cannot prove that exercise was what protected muscle. It shows the combination worked well together.
04 / Keep it in contextWhat the study cannot tell us
- Which part did the work. The program combined diet, exercise, and weight loss. The trial cannot separate how much of the remission came from each one or from how they interacted.
- How results apply to everyone. With 96 participants, this was a relatively small trial. It included adults aged 18 to 45, early in their diagnosis, living with obesity, and not on insulin. The 54% figure applies to that group under these conditions, not to everyone with type 2 diabetes.
- How long remission lasts. Follow-up ended at 24 weeks. In longer studies of similar low-calorie programs, some people stay in remission for years, while overall remission rates decline over time.
- The effect of extra attention. The intervention group had far more contact with study staff than the usual care group.
Remission means blood sugar has returned below the diabetes threshold without glucose-lowering medication. It can be lost over time, so experts recommend ongoing HbA1c testing and regular check-ups.
05 / For youWhat readers can take away
- Start with your care team. If remission interests you, talk with your doctor about whether a structured program makes sense for you. Any change to diabetes or blood pressure medication belongs with them.
- Get real nutrition support. The 800 to 900 calorie intake here was part of an intensive, medically supervised research protocol with meal replacements and dietitians. It is not a plan to try on your own.
- Train for strength and fitness. Progressive resistance and aerobic training, matched to your current level and built up over time, supports the muscle and fitness this study highlighted.
- Measure progress broadly. Bodies respond differently. Not reaching remission is not a sign of low effort or discipline, and gains in strength, fitness, blood pressure, and blood sugar still matter.
ExplainersCommon questions
What does diabetes remission mean?
An international expert group defines type 2 diabetes remission as an HbA1c below 6.5% measured at least three months after stopping glucose-lowering medication. RESET for Remission used a matching definition: below 6.5% at 24 weeks, with no glucose-lowering medication for the previous 12 weeks.
Remission describes the current state, not a permanent change. The same experts recommend continued HbA1c checks, along with routine screening for diabetes-related complications.
What is HbA1c?
HbA1c, also called A1C, is a blood test that reflects your average blood glucose over roughly the past three months. A result of 6.5% or higher is used to diagnose diabetes. At the start of this trial, participants averaged 7.2%.
Why preserve muscle during weight loss?
Muscle is the body's main site for clearing glucose in response to insulin, and it drives strength and everyday function. Weight loss from calorie restriction alone often includes some muscle loss. Keeping muscle while losing fat helps protect strength and function, which is why many researchers now treat muscle as a priority during weight loss.
In this trial, muscle volume held steady during the program. The study design cannot confirm that exercise alone caused this.
Can this study separate the effects of diet and exercise?
No. Every intervention participant received the diet and the exercise together, and the comparison group received usual care. Without diet-only or exercise-only groups, the trial cannot say how much each part contributed. The authors call for a larger, longer trial that directly compares a low-calorie diet alone with the same diet plus supervised exercise.
Why does this program require clinical supervision?
Stopping glucose-lowering and blood pressure medication while eating 800 to 900 calories a day carries real risks if done without oversight. In this trial, physicians stopped and restarted medication based on monitoring, dietitians guided the meal replacement plan, and exercise physiologists supervised training. Even so, most participants had side effects, and some had episodes of low blood sugar or low blood pressure. That is why this approach belongs with a medical team.
The bottom lineA strong signal, with room to learn
In this group of younger adults, a well-supported program of nutrition, cardio, and strength training led to remission for over half the participants while preserving muscle. Research still needs to show how long results last and which parts matter most. Your next step is a conversation with your care team and a training plan you can sustain.
Build strength alongside your care
At Teleport Strength, we provide progressive strength training, accountability, and nutrition education that work alongside the care you get from your medical team. We do not replace that care or promise medical outcomes. We help you build habits you can keep.
See How Coaching WorksSourcesReferences
- Dasgupta K, Boulé NG, Henson J, et al. Low energy diet plus supervised exercise vs. usual care alone in people with early-onset type 2 diabetes (RESET for Remission): a randomised, open-label, blinded-endpoint efficacy trial. The Lancet Regional Health (Americas). Published online October 1, 2026:101664. doi.org/10.1016/j.lana.2026.101664 (full text)
- National Institute of Diabetes and Digestive and Kidney Diseases. National Diabetes Month. niddk.nih.gov
- University of Leicester. Study shows low energy diet combined with structured exercise reverses early onset type 2 diabetes in half of participants. October 9, 2026. le.ac.uk
- Sylow L, Tokarz VL, Richter EA, Klip A. The many actions of insulin in skeletal muscle, the paramount tissue determining glycemia. Cell Metabolism. 2021;33(4):758 to 780. doi.org/10.1016/j.cmet.2021.03.020
- Anyiam O, Abdul Rashid RS, Bhatti A, et al. A systematic review and meta-analysis of the effect of caloric restriction on skeletal muscle mass in individuals with, and without, type 2 diabetes. Nutrients. 2024;16(19):3328. doi.org/10.3390/nu16193328
- Prado CM, Phillips SM, Gonzalez MC, Heymsfield SB. Muscle matters: the effects of medically induced weight loss on skeletal muscle. The Lancet Diabetes & Endocrinology. 2024;12(11):785 to 787. doi.org/10.1016/S2213-8587(24)00272-9
- Lean MEJ, Leslie WS, Barnes AC, et al. 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study. The Lancet Diabetes & Endocrinology. 2024;12(4):233 to 246. doi.org/10.1016/S2213-8587(23)00385-6
- Riddle MC, Cefalu WT, Evans PH, et al. Consensus report: definition and interpretation of remission in type 2 diabetes. Diabetes Care. 2021;44(10):2438 to 2444. doi.org/10.2337/dci21-0034
- National Institute of Diabetes and Digestive and Kidney Diseases. The A1C Test & Diabetes. niddk.nih.gov
This article is for general education and is not medical or nutritional advice. Do not start a very low-calorie diet or change any medication without guidance from your healthcare provider.