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The RESET for Remission trial found that 54% of participants assigned to a low-calorie meal-replacement diet and structured exercise met the study’s definition of type 2 diabetes remission at 24 weeks, compared with 4% receiving usual care. The result applies to adults ages 18 to 45 with relatively recent diagnoses; the trial was small, and longer-term outcomes remain unknown.
A structured low-calorie diet and exercise program put type 2 diabetes into remission for 54% of 96 young adults at 24 weeks, researchers reported, compared with 4% assigned to usual care. The randomized RESET for Remission trial focused on people diagnosed before age 45, a group at risk of developing complications earlier in life.
Remission in the trial meant an HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks. The reported adjusted odds ratio was 21.6, with a 95% confidence interval of 6.2 to 114.5. The wide interval reflects uncertainty around the size of the difference, even as the trial found a substantially higher remission rate in the intervention group.
For the first 12 weeks, participants assigned to the program received an 800-to-900-calorie daily meal-replacement diet, supervised aerobic and resistance exercise twice a week, and an independent exercise session each week. A further 12-week maintenance phase used a nutritionally optimized diet, gradually reduced meal replacements, and independent exercise. The comparison group received routine clinical care.
Participants were ages 18 to 45, with an average age of 38, and had been diagnosed within the previous six years. Their average starting HbA1c was 7.2%. At baseline, 74% were taking metformin, 20% an SGLT2 inhibitor, and a small minority a GLP-1 drug. About 90% completed the final assessment; researchers counted participants who did not complete it as not having achieved remission.
A Remission Option for Younger Adults
Early-onset type 2 diabetes can expose people to elevated glucose and potential complications at younger ages. Study presenter Kaberi Dasgupta of McGill University said those complications can arise as people begin families, relationships, or careers. A program that helps some people reach remission could offer another treatment approach for this population, alongside ongoing clinical care.
The trial also reported changes beyond HbA1c. Participants in the intervention group had improvements in several measures, including blood pressure, triglycerides, quality of life, and handgrip strength. More reached hypertension remission than in the usual-care group, 56% versus 27%. These are trial findings; they do not establish how long the changes last or whether they reduce later complications.
Co-investigator Thomas Yates of the University of Leicester argued that weight alone may not capture the program’s effects. The study reported changes in visceral and liver fat, among other fat measures. Its weight-loss figures should not be treated as a direct comparison with medication trials: RESET reported 16.5 pounds at 24 weeks, while the cited SURPASS-3 tirzepatide study reported 28.4 pounds at 52 weeks. The studies had different durations and were not a head-to-head test.
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How the 24-Week Program Worked
Earlier studies have supported low-energy meal-replacement diets as a nonsurgical way to achieve diabetes remission. The researchers said fewer studies had tested such diets together with structured, supervised exercise. RESET therefore examined both whether participants could follow the combined program and what health measures changed during it.
The trial randomized participants in equal proportions to the intervention or routine care and was open-label, meaning participants and researchers knew which group each person was in. Remission rates were reported as consistent in subgroup analyses by sex, ethnicity, and study country, according to Dasgupta’s presentation at the European Association for the Study of Diabetes meeting in Milan. The findings were also published in Lancet Regional Health Americas.
Dasgupta said the combined regimen asks a lot of participants, given the demands of a meal-replacement diet and scheduled exercise. She reported that many participants stayed in the study and liked the exercise. The completion rate offers evidence about participation in this trial, though it does not show how well the approach would fit other settings or populations.
““It’s already quite a lot to ask someone to adhere to a meal-replacement diet. Adding supervised exercise makes it even more challenging.””
— Kaberi Dasgupta, MD, MSc, McGill University
Questions About Lasting Remission
The results describe outcomes at 24 weeks; the supplied report does not establish whether participants stayed in remission later. It also remains unclear how much of the observed benefit came from the diet, the exercise, or their combination. Yates said further research is needed to confirm the added benefit of exercise.
The study involved 96 adults with recent-onset diabetes who met specific age and HbA1c criteria. The findings may not apply to older adults, people with longer-standing disease, or those outside the trial’s participating countries. The report also does not establish whether the program is accessible or sustainable at scale.
No serious adverse events were reported. Common effects included temporary headaches, constipation, dizziness, and fatigue when starting the diet, along with a slightly higher rate of mild infections in the intervention group. The trial results do not establish the program as a substitute for individualized medical care or medication decisions.
Further Trials and Follow-Up
Further research will need to test whether the remission difference persists beyond 24 weeks and clarify the additional contribution of supervised exercise. Longer follow-up could also show whether the reported changes in blood pressure, body fat measures, and other health indicators continue over time.
For now, the findings provide evidence about a specific, intensive program in younger adults with relatively recent type 2 diabetes. The next evidence needed is whether the approach can be sustained and produces durable benefits in larger and more varied groups.
Key Questions
What did the trial mean by diabetes remission?
It meant an HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks. The researchers assessed remission at the 24-week point.
How many participants reached remission?
At 24 weeks, 54% of the intervention group met the study definition, compared with 4% receiving usual care. The trial enrolled 96 people in total.
What did the diet and exercise program involve?
For 12 weeks, participants followed an 800-to-900-calorie meal-replacement diet, attended supervised aerobic and resistance exercise twice weekly, and exercised independently once weekly. A 12-week maintenance phase followed.
Were serious side effects reported?
The report said there were no serious adverse events. Temporary headaches, constipation, dizziness, and fatigue were among the common effects; mild infections were slightly more frequent in the intervention group.
Does the study show that remission lasts?
No. The reported outcome was measured at 24 weeks. Longer follow-up is needed to determine whether participants remain in remission and whether the program’s other reported changes persist.
Source: rss
