Diet and Exercise Put 54% of Early Type 2 Diabetes Cases in Remission

Researchers enrolled 96 adults ages 18 to 45 who had obesity and early-onset type 2 diabetes but did not use insulin. Participants were randomly assigned to usual care or a 24-week lifestyle program at three study sites located in Canada and England. Enrollment ran from September 24, 2021 through June 6, 2025, and 86 participants completed the final assessment.

During weeks 1-12, the intervention group followed an 800-900 kcal/day eating plan. The program began with two weeks of complete meal replacement, then introduced more variety and one food-based meal daily. Participants also completed supervised aerobic and resistance sessions twice each week, plus one independent weekly workout. Weeks 13-24 shifted to weight maintenance and independent activity. Glucose- and blood pressure-lowering medicines were stopped when the diet began, except under the specified albuminuria condition.

At 24 weeks, 27/50 people in the intervention group were in remission, compared with 2/46 receiving usual care. After adjustment, remission was 21 times more likely with the combined program. Intervention participants lost an average of 8.4 kg, versus 1.2 kg in the control group; the adjusted difference was 7.5 kg, including 6.6 kg more fat loss. Muscle and fat-free mass were preserved during rapid weight reduction, supporting physical function alongside improvements in fitness and cardiovascular health. No severe adverse events occurred. However, 43/50 intervention participants reported at least one event, most often constipation, headache, dizziness or fatigue early in the low-energy phase; these effects resolved. Longer-term study is needed to examine muscle preservation and weight regain.