By Joke Kujenya
FOR THOUSANDS of younger adults living with type 2 diabetes, the prospect of spending decades managing the condition could look different if an intensive combination of food restriction and physical activity delivers on its promise.
JKNewsMedia.com reports that new research, tagged RESET for Remission (R2), suggests that more than half of participants in a clinical trial achieved remission within six months, raising fresh possibilities for tackling the condition earlier in life.
The R2 team announced that twenty-seven of the 50 participants who followed the structured lifestyle programme recorded remission after 24 weeks, compared with just two among 46 people receiving standard medical care.
The difference, R2 researchers say, points to the potential of combining a low-calorie diet with supervised exercise to change the course of early-onset type 2 diabetes.
Published in The Lancet Regional Health Americas and presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), the findings emerged from a clinical trial involving research centres in England and Canada.
The R2 study focused on adults aged 18 to 45 who had type 2 diabetes and obesity but were not using insulin.
Its central question was whether substantial weight loss, supported by structured aerobic and resistance training, could help younger patients achieve remission rather than simply manage their blood sugar levels.
For participants assigned to the intensive programme, the first 12 weeks demanded significant changes to everyday eating habits.
Their daily calorie intake was restricted to between 800 and 900 calories, with meals initially replaced by specially formulated nutritional products.
Also, the programme subsequently introduced greater flexibility, allowing one conventional meal daily while maintaining the calorie restriction and prescribed nutritional targets.
Participants also undertook supervised aerobic and resistance exercise twice weekly, with an additional independent session.
During the final 12 weeks, they moved towards maintaining their weight loss and continued exercising independently.
The results were striking.
Of the 50 people assigned to the intervention, 27 achieved remission, giving the programme a success rate of 54 per cent. Only four per cent of those receiving standard care reached the same outcome.
The trial, conducted by Professor Kaberi Dasgupta, Director of the Division of General Internal Medicine at McGill University in Montreal, and Professor Thomas Yates of the University of Leicester, alongside colleagues, calculated that participants following the intensive programme were 21 times more likely to achieve remission after accounting for relevant statistical factors.
The weight figures offered another measure of the difference.
Participants in the intervention group lost an average of 8.4 kilograms over six months, compared with 1.2 kilograms among those receiving standard care.
Statistical adjustments showed that the intervention produced an additional 7.5 kilograms of weight loss, including 6.6 kilograms of additional fat reduction.
But the research went beyond the numbers on a weighing scale.
One of its important considerations was whether people could lose substantial amounts of weight without sacrificing muscle, a concern associated with restrictive weight-loss programmes.
Researchers incorporated resistance training to help protect muscle during the intensive weight-loss phase.
Their findings actually indicated that participants could reduce body fat while preserving fat-free mass, which includes muscle.
That distinction matters because the research team warned that repeated cycles of weight loss and regain could leave people with proportionally less lean tissue.
Over time, this could contribute to sarcopenia, a condition involving declining muscle mass and strength.
The researchers said their R2 study demonstrated that resistance training could help preserve muscle during rapid weight loss, although they stressed that longer-term research would be necessary to establish the lasting benefits.
They noted that between Sept. 24, 2021, and June 6, 2025, the team enrolled 96 participants across the UK and Canada.
Forty joined through the UK research centre, while 56 came from Canada. Eighty-six participants, representing 90 per cent of those enrolled, completed the final assessments.
For the study, remission meant recording an HbA1c level below 6.5 per cent, equivalent to 48 mmol/mol, without taking glucose-lowering medication for at least 12 weeks. HbA1c measures average blood glucose levels over approximately three months.
Remission, however, does not mean a permanent cure, they cautioned.
The team of Dasgupta and Yates also emphasised the need to establish whether participants can maintain their weight loss, muscle mass and improved blood sugar levels after leaving the closely supervised trial environment as the intensive programme came with discomfort.
At least one adverse event was reported by 43 intervention participants, compared with six people receiving standard care.
Constipation, headaches, dizziness and fatigue featured among the complaints, particularly during the early stages of the restrictive diet as Dasgupta and Yates noted.
The duo reported no severe adverse events, and most of the reported symptoms resolved.
The study’s authors both described the findings as evidence that combining a low-energy diet with structured exercise could deliver benefits extending beyond blood sugar control, including improvements in muscle quality, physical performance, cardiovascular health and participants’ reported well-being.
They also identified potential relevance for people planning a pregnancy or who may become pregnant.
For younger adults, the stakes extend beyond the immediate challenge of managing a diagnosis.
Early-onset type 2 diabetes exposes people to elevated blood sugar for more years, with researchers highlighting the associated risks of cardiovascular disease, an earlier burden of complications and poorer long-term outcomes.
The researchers said their findings support reconsidering treatment approaches for this growing clinical population, with integrated dietary and exercise interventions offering a potential route towards remission.
But whether the encouraging six-month results can translate into lasting changes remains an important unanswered question, the due further said.
They then advocated that longer-term studies, particularly in everyday settings, will need to establish whether participants can sustain the improvements once the intensive programme ends.
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