A diagnosis of type 2 diabetes before the age of 45 can create significant long-term health challenges. People diagnosed at a younger age may spend more years managing elevated blood glucose and face an increased likelihood of developing complications earlier in life.
However, new research offers encouraging evidence that a carefully supervised combination of dietary changes and physical activity may help some younger adults achieve diabetes remission.
The RESET for Remission trial, published in The Lancet Regional Health – Americas on October 1, 2026, examined whether an intensive low-energy eating plan combined with structured exercise could improve outcomes. After 24 weeks, more than half of the participants following the programme achieved remission, compared with a small proportion receiving standard care.
<h3>What the Researchers Investigated</h3>
The clinical trial involved 96 adults aged between 18 and 45 from research centres in England and Canada. All participants had early-onset type 2 diabetes, were living with obesity and were not receiving insulin treatment. Researchers randomly assigned participants to two groups. One continued with usual medical care, while the other followed a structured programme combining a low-energy diet and supervised physical activity.
During the first 12 weeks, participants in the intervention group consumed approximately 800 to 900 calories daily. The programme included meal replacements during the initial two weeks, followed by a more flexible eating plan that allowed one regular meal each day. The dietary approach emphasized protein, fruit and non-starchy vegetables.
<h3>More Than Half Achieved Remission</h3>
At the end of the six-month trial, 27 out of 50 participants in the diet-and-exercise group achieved remission. This represented 54% of that group, compared with only two participants, or 4%, receiving usual care. Researchers defined remission using a specific medical measurement: glycated haemoglobin (HbA1c) below 6.5%, without glucose-lowering medication for at least 12 weeks.
The intervention group also experienced greater average weight reduction. Participants lost approximately 8.4 kilograms, compared with 1.2 kilograms in the standard-care group. The difference between the groups was around 7.5 kilograms after statistical adjustment. Importantly, the exercise component helped preserve muscle mass during the period of weight reduction.
<h3>Why Exercise Was an Important Part of the Programme</h3>
Dietary changes can improve blood glucose control, but exercise provides additional metabolic benefits. Aerobic activities, such as brisk walking and cycling, encourage muscles to use glucose for energy and can improve cardiovascular fitness. Resistance training offers a different advantage. Activities involving controlled lifting or bodyweight movements help maintain and develop muscle.
Combining both forms of activity may therefore support blood glucose regulation while helping preserve physical function during dietary changes. The trial also examined improvements in fitness, muscle quality and heart structure.
<h3>Expert Insight</h3>
David Cutler, MD, a board-certified family medicine physician at Providence Saint John's Health Center in California, commented on the findings for Healthline. Although he was not involved in the research, he highlighted the potential value of combining lifestyle changes: “This study proves what most physicians have advocated for quite some time. Clearly, diet and exercise can work to improve or even resolve diabetes.”
<h3>Important Limitations and Safety Considerations</h3>
The results are promising, but several limitations remain. The trial included only 96 participants and followed them for 24 weeks. Longer research is necessary to establish how many people maintain remission over several years. The programme also required close medical supervision. Most participants in the intervention group experienced at least one adverse effect, particularly during the early dietary phase.
An eating plan providing only 800 to 900 calories daily is highly restrictive and should not be attempted without professional guidance. Changes in food intake and activity can affect blood glucose and medication requirements. Adjustments must therefore be managed by qualified healthcare professionals.
<h3>Building Sustainable Habits After Treatment</h3>
The programme's longer-term success depends partly on maintaining changes after the intensive phase ends. Balanced meals, regular movement and consistent health monitoring can help support glucose control. For everyday activity, walking after meals, cycling, swimming and suitable resistance exercises can contribute to a more active routine. Food choices emphasizing vegetables, whole grains, protein sources and high-fibre ingredients can also support metabolic health.
The RESET for Remission trial found that a supervised low-energy diet combined with structured exercise helped 54% of participants with early-onset type 2 diabetes achieve remission after six months. The programme also improved several measures of physical health while helping preserve muscle.
Although the findings offer encouraging possibilities, the intervention was intensive and involved close professional supervision. Larger and longer studies are needed to understand its lasting effects. The research nevertheless highlights the potential of combining nutrition and exercise as part of a carefully managed approach to early-onset type 2 diabetes.
