Key Takeaways
- 54% of intervention participants achieved diabetes remission at 24 weeks.
- The intervention group lost 7.5 kg more than usual-care participants.
- Diabetes reversal findings included reduced fat mass and improved muscle quality.
- Cardiorespiratory fitness improved by 10.3% compared with usual care.
Imagine checking your blood sugar one morning and seeing a reading you have not seen in years. For someone living with type 2 diabetes, that moment could raise a powerful question: is diabetes reversal possible through changes in diet and exercise? The idea has drawn growing interest, but what does the scientific evidence actually show? A clinical trial called RESET for Remission set out to explore this question in younger adults with early-onset type 2 diabetes.
The researchers tested a structured programme that combined a low-energy diet with supervised exercise. Their aim was to find out whether this approach could help participants achieve diabetes reversal. The findings offer a closer look at the potential of lifestyle changes and raise important questions about what drives the benefits and how long they might last.
What did the RESET for Remission trial investigate?
The RESET for Remission trial tested whether a low-energy diet combined with supervised exercise could help younger adults with type 2 diabetes achieve remission. Remission means blood sugar levels have fallen below the diabetes range without the use of glucose-lowering medication for at least three months. We reported previously that higher red meat intake was associated with higher diabetes risk. The researchers enrolled 96 adults aged 18 to 45 in England and Canada. All had obesity and had received a type 2 diabetes diagnosis within the previous six years. None was receiving insulin treatment.
The researchers randomly assigned 50 participants to the intervention group and 46 to a usual-care group. The intervention had two stages. For the first 12 weeks, participants followed a low-energy diet of 800 to 900 calories per day and took part in a supervised exercise programme. This included two supervised sessions each week, with aerobic and resistance exercise, plus one independent session. During the next 12 weeks, participants reintroduced food and worked to maintain their weight loss while continuing the exercise programme. The comparison group received usual care.
The main outcome was diabetes remission at 24 weeks. The researchers defined remission as an HbA1c level below 6.5% (48 mmol/mol), without glucose-lowering medication for at least 12 weeks.
Can this approach lead to diabetes reversal?
At 24 weeks, 27 of the 50 participants in the diet and exercise group met the remission target. That is 54% of the group. In the usual-care group, 2 of 46 participants, or about 4%, met the same target. The difference between the groups was 50 percentage points. The researchers also reported an adjusted odds ratio of 21.6, with a 95% confidence interval of 6.2 to 114.5. The results at 12 weeks were similar. At that point, 29 of the 50 participants in the intervention group, or 58%, had reached the remission target.
These findings help explain why diabetes reversal has become an important research question. More than half of the participants in the intervention group reached blood sugar levels below the diabetes threshold without medication. However, the researchers describe this outcome as remission, not a permanent reversal or cure. The study also cannot tell us whether the results will last beyond 24 weeks.
Weight loss and changes in body composition
The intervention group also lost more weight than the usual-care group. The adjusted difference in weight change between the groups was 7.5 kg in favour of the diet and exercise programme. The researchers also found a greater reduction in fat mass. The intervention group had a 16.5% greater reduction in fat mass than the usual-care group. Previous research has also examined the relationship between weight loss and chronic disease risk, including type 2 diabetes.
The findings on muscle were more mixed. The study found no clear difference between the groups in fat-free mass or muscle volume. However, it did find a reduction in myosteatosis, a measure of fat within muscle, in the intervention group. Handgrip strength also improved, with a 7.6% difference between the groups.
These results matter because weight loss does not tell the whole story. Changes in muscle quality and strength may offer a broader view of how the body responds to a weight-loss programme. The trial, however, does not establish how long these changes last.
Fitness and other health measures also improved
Participants in the intervention group showed a 10.3% improvement in cardiorespiratory fitness relative to body weight compared with the usual-care group. The researchers also reported improvements in several measures linked to metabolic health, blood pressure, triglycerides, liver and pancreatic fat, and quality of life. However, exercise alone often leads to modest weight loss, which is one reason researchers study combined diet and exercise programmes.
The trial examined heart structure as well. The intervention group showed an increase in left ventricular end-diastolic volume and a decrease in the ratio of heart muscle mass to volume. However, there was no significant between-group difference in early diastolic strain rate.
These findings point to changes in some measures of heart structure, but they do not prove that the programme improved overall heart function or reduced the risk of future heart disease.
What about safety?
No serious adverse events were reported during the trial. At least one adverse event was recorded in 43 of the 50 participants in the intervention group, compared with 6 of the 46 participants in the usual-care group. This difference needs context. Participants in the intervention group had more contact with the research team, which may have led to more frequent detection and reporting of adverse events. The figures should not be read as a direct measure of the programme’s overall safety compared with usual care.
What are the limits of the diabetes reversal findings?
The results are encouraging, but several limits matter when interpreting them. First, the trial did not include a diet-only group. The researchers therefore cannot separate the effect of the low-energy diet from the added effect of exercise. The findings apply to the combined programme, not to either part on its own.
Second, the intervention group had more contact with the research team than the usual-care group. This means that the effects of the programme cannot be separated fully from the effects of extra support and attention. The study also had limits in how it measured adherence. Researchers could not track unsupervised exercise as closely as supervised sessions, and self-reported dietary intake was incomplete.
The participants were also a specific group: younger adults with obesity, relatively recent type 2 diabetes diagnoses, and no insulin treatment. The findings may not apply to older adults, people who have had long-time hopes on diabetes reversal, or those who use insulin. Finally, the trial lasted only 24 weeks. It cannot tell us whether participants will maintain their weight loss or remain in remission over the long term. This is a key gap in the evidence on diabetes reversal.
What do these findings mean for diabetes reversal?
Concerns about the link between diabetes drugs and depression are driving interest in diabetes reversal through lifestyle changes that may reduce or eliminate the need for medication. The RESET for Remission trial adds evidence that a structured programme combining a low-energy diet with supervised exercise can help some younger adults with early-onset type 2 diabetes reach remission over a short period. The results extend beyond blood sugar levels. The researchers also found changes in body fat, muscle quality, fitness, and several other health measures. Together, these findings offer a wider picture of how the participants responded to the programme.
But the study does not prove that diabetes reversal is permanent. It also does not show how much of the benefit came from diet, how much came from exercise, or whether the results will continue after the programme ends. The key question now is whether participants can maintain these changes and remain in remission over a longer period. Further research with longer follow-up and separate diet and exercise comparison groups could help answer that question. For now, the trial offers promising evidence about diabetes reversal, but not proof of a lasting cure.
Research details
- Study: RESET for Remission
- Design: Randomised, open-label, blinded-endpoint efficacy trial
- Participants: 96 adults aged 18 to 45 with obesity and early-onset type 2 diabetes
- Intervention: A 12-week low-energy diet with supervised aerobic and resistance exercise, followed by 12 weeks of food reintroduction, weight maintenance, and continued exercise
- Main outcome: Diabetes remission at 24 weeks
- Study locations: England and Canada
- Publication: THE LANCET Regional Health – Americas
- Full publication details: Low energy diet plus supervised exercise vs. usual care alone in people with early-onset type 2 diabetes (RESET for Remission): a randomised, open-label, blinded-endpoint efficacy trial.
FAQs on Diabetes Reversal
Q: Can type 2 diabetes be reversed permanently?
A: Type 2 diabetes can go into remission in some people, but this does not mean that permanent diabetes reversal is possible. Blood sugar levels can rise again, so ongoing health checks remain important. The RESET for Remission trial followed participants for only 24 weeks and could not establish whether remission would last.
Q: How did diet and exercise help people with type 2 diabetes reversal mission?
A: In the RESET for Remission trial, participants followed an 800 to 900 calorie daily diet for 12 weeks and took part in supervised aerobic and resistance exercise. They then moved to food reintroduction, weight maintenance, and continued exercise for another 12 weeks. At the end of the trial, 54% of the intervention group had reached the study’s remission target.
Q: What percentage of people reversed type 2 diabetes in the RESET trial?
A: About 54% of participants in the diet and exercise group reached remission after 24 weeks, compared with about 4% in the usual-care group. This means 27 of 50 people in the intervention group met the study’s target, which required an HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks.
Q: What is the difference between diabetes reversal and diabetes remission?
A: People often use the term diabetes reversal to describe a return to non-diabetic blood sugar levels. In medical research, remission is the preferred term because blood sugar levels can rise again. Remission does not mean that the condition has disappeared permanently or that future monitoring is no longer needed.
Q: Can losing weight help reverse early-stage type 2 diabetes?
A: Weight loss can help some people with type 2 diabetes reversal mission, particularly when the condition is diagnosed relatively early. In the RESET trial, the intervention group lost an adjusted average of 7.5 kg more than the usual-care group. The trial supports the combined diet and exercise programme, but it cannot show how much of the benefit came from weight loss alone.
Q: Is diet alone enough to put type 2 diabetes into remission, or is exercise also needed?
A: The RESET trial cannot answer this question because it did not include a diet-only or exercise-only group. All participants in the intervention group followed both the low-energy diet and the supervised exercise programme. Separate comparison groups would be needed to measure the individual effects of diet and exercise.
Q: Who may benefit from a type 2 diabetes remission programme?
A: The RESET trial studied adults aged 18 to 45 who had obesity, had received a type 2 diabetes diagnosis within the previous six years, and were not using insulin. Its results are most directly relevant to people with similar characteristics. The study does not establish whether the same programme would produce similar results in older adults or people with longer-standing diabetes.
Q: How much does a diabetes reversal diet and exercise programme cost?
A: The RESET for Remission study did not report the cost of running the programme or what participants would pay to follow it outside the trial. Costs may depend on access to meal replacements, dietary support, supervised exercise, and clinical monitoring. The study does not provide enough information to estimate a typical programme cost.
Q: How long does it take to put type 2 diabetes into remission?
A: In the RESET trial, some participants reached the remission target by week 12. By week 24, 54% of the intervention group had achieved it. These results describe the trial participants, not a guaranteed timeline for other people, and the study did not establish how long remission would continue.
References
- Dasgupta K, Boulé NG, Henson J, Redman E, Chan D, McCarthy M, Rosa D, Arsenyadis F, Chevalier S, Rees JL, Lim J. Low energy diet plus supervised exercise vs. usual care alone in people with early-onset type 2 diabetes (RESET for Remission): a randomised, open-label, blinded-endpoint efficacy trial. The Lancet Regional Health–Americas. 2026 Oct 1. DOI: 10.1016/j.lana.2026.101664. Also available from: https://www.sciencedirect.com/science/article/pii/S2667193X26002942
- The British Diabetic Association operating as Diabetes UK. What is type 2 diabetes remission? Available from: https://www.diabetes.org.uk/about-diabetes/type-2-diabetes/remission/what-is-type-2-diabetes-remission
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