Type 2 diabetes diagnosed at a younger age can create a longer period of exposure to elevated blood glucose, increasing the potential for long-term health complications.

Although medication remains important for many people, research suggests that intensive dietary changes combined with structured physical activity may help some individuals achieve diabetes remission.

Understanding Early-Onset Type 2 Diabetes

Early-onset type 2 diabetes refers to a diagnosis made before the age of 45. Unlike type 1 diabetes, which involves an autoimmune process that damages insulin-producing cells, type 2 diabetes commonly develops when the body becomes less responsive to insulin and cannot produce enough insulin to maintain normal blood glucose levels.

Insulin is a hormone that helps glucose move from the bloodstream into cells, where it can be used for energy. When insulin resistance develops, glucose may accumulate in the blood. Over time, persistently elevated glucose can damage blood vessels and contribute to complications affecting the kidneys, eyes, nerves, and heart.

What the Clinical Trial Discovered

The RESET for Remission trial, published in The Lancet Regional Health – Americas in October 2026, investigated whether combining dietary energy restriction with structured exercise could help people with early-onset type 2 diabetes achieve remission.

The randomized trial included 96 participants aged 18–45 who had type 2 diabetes and obesity and were not receiving insulin therapy. Participants were assigned either to usual care or to an intensive lifestyle intervention combining a low-energy diet with supervised physical activity.

During the first 12 weeks, participants in the intervention group followed a daily eating plan providing approximately 800–900 calories. They also completed supervised aerobic and resistance exercise twice weekly, along with an additional independent session each week. For the following 12 weeks, participants transitioned to a weight-maintenance eating plan and continued exercising independently.

At the end of the 24-week study, 27 of the 50 participants in the intervention group achieved diabetes remission, compared with two of the 46 participants receiving usual care. These results corresponded to remission rates of 54% and 4%, respectively.

The intervention group also experienced greater weight reduction and improvements in physical fitness and several measures of cardiovascular health. These findings suggest that combining dietary changes with structured exercise may provide benefits beyond blood glucose control alone.

How Diet and Exercise May Improve Glucose Control

The intervention combines two approaches that influence glucose regulation through different but complementary mechanisms.

Reduced energy intake: A carefully planned low-energy diet can help the body use stored energy and reduce excess energy accumulation in the liver and other tissues.

Aerobic exercise: Activities such as brisk walking, cycling, and swimming encourage working muscles to use glucose for energy. Regular aerobic activity can improve insulin sensitivity and cardiovascular fitness.

Resistance training: Exercises involving weights, resistance bands, or body weight help preserve and build muscle. Muscle tissue plays an important role in glucose disposal, making resistance training a valuable component of diabetes management.

Expert Insight

Professor Thomas Yates, Professor of Physical Activity and Health at the University of Leicester and a co-author of the trial, highlighted the significance of combining dietary intervention with structured exercise. Yates stated: “Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise with a low energy diet in early onset type 2 diabetes, supporting its potential to deliver substantial and holistic health and well-being benefits alongside diabetes remission.”

What Diabetes Remission Really Means

Diabetes remission does not mean that the condition has been permanently cured. In this trial, remission was defined as a glycated hemoglobin (HbA1c) level below 6.5% without glucose-lowering medication for at least 12 weeks. HbA1c reflects average blood glucose levels over approximately two to three months. A value below the diabetes threshold indicates improved glucose control, but continued monitoring remains necessary.

Safety and Practical Considerations

An eating plan providing only 800–900 calories daily is highly restrictive and should not be attempted without appropriate medical supervision. In the trial, participants experienced side effects including constipation, headaches, dizziness, and tiredness, although these effects generally resolved.

Medication management is another critical consideration. Changes in food intake and physical activity can alter blood glucose and blood pressure, potentially requiring adjustments to prescribed treatment. Medication should never be stopped or modified without direct guidance from the treating healthcare professional.

Diabetes remission is possible for some people, but it requires continued monitoring and does not represent a permanent cure. Medically supervised dietary changes, regular physical activity, and individualized treatment can help support better metabolic health and reduce the risk of future complications.