Intensive diet‑exercise program drives 54% remission in early‑onset type 2 diabetes
A six‑month trial found more than half of participants under 45 achieved diabetes remission using a low‑calorie diet and supervised exercise.
Study design and participants
The trial was open‑label and randomized across three research centres in England and Canada, affiliated with the University of Leicester, McGill University and the University of Alberta. It enrolled adults aged 18‑45 who had early‑onset type 2 diabetes (EOT2D) and obesity, but were not using insulin. All participants discontinued glucose‑lowering and blood‑pressure medicines under supervision at the start of the intensive arm.
Intervention details
One group continued with usual care. The experimental group followed a 24‑week intensive programme. For the first 12 weeks participants consumed 800‑900 kcal per day (30 % protein, 50 % carbohydrate, 20 % fat), drank at least two litres of calorie‑free fluids daily and could use a fibre‑based laxative as needed. They also performed supervised aerobic and resistance exercise twice weekly and added one unsupervised session each week.
Weeks 13‑24 shifted to a weight‑maintenance diet while participants exercised independently.
Remission outcomes
Remission was defined as an HbA1c below 6.5 % (48 mmol/mol) without any glucose‑lowering medication for at least 12 weeks. Using an intention‑to‑treat analysis that counted missing data as non‑remission, 54 % of the intensive‑program participants achieved remission after 24 weeks, compared with 4 % in the standard‑care group.
Additional measurements
The researchers also tracked changes in cardiovascular fitness, body composition and cardiac structure, though the source does not detail those results.
Context and implications
Early‑onset type 2 diabetes is noted for rapid deterioration of blood‑sugar control, earlier complications and reduced life expectancy. Prior studies have shown very low‑calorie diets can induce remission, but this trial tested whether adding structured exercise would boost effectiveness. The findings, presented at the European Association for the Study of Diabetes annual meeting and published in The Lancet Regional Health Americas, suggest that a combined diet‑exercise approach may substantially alter the trajectory of EOT2D, though remission does not equate to a permanent cure.
