A Trial in Young Adults Put Type 2 Diabetes Into Remission for More Than Half. The Programme Was Intensive and Medically Supervised
A randomised trial has reported that 54% of young adults with obesity and recently diagnosed type 2 diabetes reached remission after 24 weeks of an intensive lifestyle programme, compared with about 4% of those who received usual care. The results were published in The Lancet Regional Health – Americas, from researchers at McGill University and the University of Leicester, and were presented at the European Association for the Study of Diabetes (EASD) meeting.
Who took part and what they did
The RESET for Remission trial enrolled 96 adults aged 18 to 45 who had obesity and early-onset type 2 diabetes, diagnosed at least three months and no more than six years earlier. None used insulin.
The intervention combined an 800 to 900 calorie daily diet with supervised aerobic and resistance training for 12 weeks, followed by a healthy weight-maintenance plan and continued exercise for another 12 weeks. The comparison group received usual care.
The results
At 24 weeks, 27 of 50 participants (54%) in the intervention group were in remission, against 2 of 46 (about 4%) in the usual-care group. The adjusted odds ratio was 21.6; an odds ratio is not the same as a relative risk.
What the study cannot tell us
- It is small: 96 people.
- It was open-label, so participants and staff knew who received which treatment.
- It had no diet-only arm, so the trial cannot separate the effect of the diet from the effect of the supervised exercise.
- The follow-up reported is six months. Whether remission lasts is a separate question that this paper does not answer.
- It tested younger adults, so its results should not be assumed to apply to older people or to those with longer-standing diabetes.
Why a daily 800–900 calorie diet is not a do-it-yourself plan
The diet in the trial was part of a supervised programme. Very-low-calorie diets can interact with diabetes medicines and affect blood sugar, blood pressure and other conditions, which is why medical supervision is essential. Anyone with diabetes who is considering major dietary change should talk to their doctor first.
Our analysis
The strength of this result is its size against the comparison group, and it matters for the age group: early-onset type 2 diabetes tends to progress faster and with more complications. The weakness is that the trial leaves unanswered what most patients will ask first, which is how much of the effect comes from the diet and how much from exercise, and how long it lasts. Larger trials with longer follow-up are the obvious next step. India has a large and young population living with type 2 diabetes, which is why the question deserves a proper answer, but this trial does not itself test an Indian population or diet.
*This article is for information and is not medical advice.*
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