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A 24-week randomized trial found that 27 of 50 adults with early-onset type 2 diabetes entered remission after a medically supervised 800–900-kilocalorie daily diet combined with structured exercise. That was 54% of the intervention group, compared with 2 of 46 people, or 4%, receiving usual care. The result is promising, but remission in this study was a defined short-term outcome—not proof that diabetes has been permanently cured.
What the RESET for Remission trial tested
The RESET for Remission study was an open-label, randomized trial with blinded endpoint assessment. It enrolled 96 adults aged 18 to 45 at three centres in England and Canada. All participants had early-onset type 2 diabetes and obesity, and none was using insulin.
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The intervention combined rapid, intensive weight loss with resistance and aerobic exercise. Participants followed the program for 24 weeks, while the control group continued usual diabetes care.
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For the first two weeks, participants consumed total meal replacements providing 800–900 kcal per day. During weeks 3 through 12, meal replacements continued alongside one food-based meal each day. Optifast was used at the UK centre and ProtiDiet in Canada.
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From week 13 to week 24, the program shifted to a weight-maintenance diet rather than continuing the most restrictive phase.
The exercise phase
During weeks 1–12, participants completed two supervised sessions each week combining aerobic and resistance training, plus one independent exercise session. During weeks 13–24, they continued independent exercise while following the weight-maintenance diet.
How remission was defined
Remission did not mean that the disease had disappeared permanently. The trial required both conditions below at the 24-week assessment:
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- HbA1c below 6.5% (48 mmol/mol).
- No glucose-lowering medication for at least 12 weeks.
Using that definition, 27 of 50 intervention participants achieved remission, compared with 2 of 46 in usual care. The University of Leicester reported that adjusted analysis found participants in the intervention were 21 times more likely to reach remission.
Results beyond blood sugar
Weight and fat loss
Intervention participants lost an average of 8.4 kg from baseline to week 24. The usual-care group lost 1.2 kg. After adjustment, the difference between groups was 7.5 kg, including 6.6 kg more fat-mass loss in the intervention group.
Muscle and fitness
MRI assessments indicated that muscle mass was preserved despite rapid weight loss. Strength, cardiorespiratory fitness and muscle quality improved. The University of Leicester also reported a positive change in heart structure.
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These findings matter because rapid calorie restriction can raise concerns about losing muscle as well as fat. In this trial, resistance training was deliberately included during the intensive weight-loss period rather than treating exercise as an optional extra.
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Trial outcomes at a glance
| Measure | Diet-and-exercise group | Usual-care group |
|---|---|---|
| Participants | 50 | 46 |
| Remission at 24 weeks | 27 participants (54%) | 2 participants (4%) |
| Average weight change | −8.4 kg | −1.2 kg |
| Reported adverse events | 43 participants | 6 participants |
| Final-assessment attendance | 86 of 96 randomized participants (90%) | |
The remission and attendance figures were reported by the NIHR Leicester Biomedical Research Centre in 2026; the weight, body-composition and adverse-event findings were also reported by the University of Leicester in 2026.
Safety and medication warnings
No severe adverse events were reported. However, 43 of 50 intervention participants experienced at least one adverse event, compared with 6 of 46 controls. The most common problems were constipation, headache, dizziness and fatigue, particularly early in the low-energy diet. The reports say these effects resolved.
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The study protocol also stopped glucose-lowering and blood-pressure-lowering medicines when the diet began. That was a monitored research procedure, not a self-care instruction. Anyone taking diabetes or blood-pressure medication should speak with their clinician before changing the dose or stopping treatment. A meal-replacement diet at this calorie level requires medical oversight, including monitoring for low blood sugar, dehydration, blood-pressure changes and other complications.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Who these results apply to—and who they may not
The participants were younger adults with obesity, early-onset type 2 diabetes and no insulin therapy. The results therefore cannot automatically be extended to older adults, people without obesity, people using insulin, or people with type 1 diabetes or other forms of diabetes.
The study also lasted only 24 weeks. The trial reports note that weight regain commonly follows low-energy diets, and longer studies are needed to establish how many participants remain in remission and whether the program can be delivered reliably in ordinary healthcare settings.
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What the findings mean for someone considering remission
- Confirm the diagnosis and starting point. Early-onset type 2 diabetes is not interchangeable with type 1 diabetes or every other cause of high blood sugar.
- Use a qualified clinical team. The trial involved structured supervision, prescribed meal replacements, exercise coaching and medication management.
- Ask how medicines will be monitored. Medication changes should be planned with the diabetes clinician, with an agreed schedule for glucose and blood-pressure checks.
- Include resistance training safely. The study’s muscle-preservation result came from combining calorie restriction with both aerobic and resistance exercise, not from dieting alone.
- Plan for maintenance before starting. The intervention moved to a weight-maintenance diet after 12 weeks because maintaining the result is a separate challenge from losing weight quickly.
Remission is not the same as a cure
In this trial, remission meant meeting the HbA1c threshold without glucose-lowering medication for the specified period at one follow-up point. It does not guarantee that blood sugar will remain below the threshold indefinitely, nor does it eliminate the need for future monitoring. Weight regain can bring diabetes back, which is why the durability of these results remains an open question.
The study authors described the combination of structured aerobic and resistance exercise with a low-energy diet as feasible and capable of producing substantial health and well-being benefits alongside remission. Their findings support clinician-led programs for appropriately selected patients, while leaving long-term maintenance and broader eligibility for future research.
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