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Half of young adults with early-onset type 2 diabetes reach remission without drugs

Half of young adults with early-onset type 2 diabetes reach remission without drugs

New Capabilities

24-week program of low-calorie diet plus supervised exercise reversed diabetes in 54% of participants in a randomized trial

October 2nd, 2026: Main results published

Overview

Updated 1 hour ago

A 24-week program of very low-calorie diet plus supervised strength and cardio training put early-onset type 2 diabetes into remission in 54% of participants, versus 4% of a usual-care group. Remission meant a blood-sugar marker under 6.5% without diabetes medication for at least 12 weeks.

The randomized trial enrolled 96 adults averaging 38 years old at three centers in England and Canada. Participants lost fat while keeping muscle, improved fitness and heart structure, and had no serious side effects. Results were published in The Lancet Regional Health – Americas on October 2, 2026.

Why it matters

This trial suggests young adults with early-onset type 2 diabetes may avoid decades of medication. Half reached remission with diet and exercise alone.

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Key Indicators

54%
Remission at 24 weeks (intervention)
27 of 50 participants reached remission vs 2 of 46 (4%) in usual care; adjusted odds ratio 21.6.
38
Average participant age
Trial enrolled adults 18–45 with early-onset type 2 diabetes and obesity (average BMI 35.2).
96
Participants randomized
Across three centers in England and Canada, September 2021 to June 2025.
-7.5 kg
Weight loss vs control
Intervention group lost 7.0% of body weight (about 8.4 kg) by 24 weeks, mostly fat mass.
16.5%
Fat mass loss (intervention effect)
DXA-assessed fat loss with fat-free mass preserved; muscle strength and cardiorespiratory fitness rose.

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People Involved

KD
Kaberi Dasgupta
Senior investigator, RESET for Remission trial
Announced the trial's main results in October 2026

Organizations Involved

University of Leicester
University of Leicester
University / trial center
One of three clinical centers in the RESET for Remission trial

A UK university whose researchers helped run the RESET for Remission trial.

Timeline

September 2021 October 2026

4 events Latest: October 2nd, 2026 · 2 weeks ago
Tap a bar to jump to that date

  1. Main results published

    Latest Publication

    Paper in The Lancet Regional Health – Americas: 54% remission vs 4% in control.

  2. Results presented at EASD

    Conference

    Findings presented at the European Association for the Study of Diabetes annual meeting.

  3. Recruitment closes

    Trial

    96 participants randomized across three centers in England and Canada.

  4. Recruitment opens

    Trial

    RESET for Remission begins enrolling adults 18–45 with early-onset type 2 diabetes at three centers.

Scenarios

1

Remission holds beyond the program

Uncertain Resolves by Oct 2, 2028

Discussed by: Trial authors (who call for longer-term studies) and endocrinologists on social media; one analysis flags that two-year data will matter more than six-month results.

The 24-week program ends with high remission, but the paper acknowledges durability is unknown. If a follow-up report shows most of the 27 who remitted stay off medication at 12 months or beyond, the approach gains real weight. If remission fades, the trial becomes a proof-of-concept with limited clinical reach.

2

Exercise's marginal benefit gets tested head-to-head

Possible Resolves by Oct 2, 2030

Discussed by: The paper's own conclusion calls for comparing low-energy diet alone against diet combined with supervised exercise.

RESET combined diet and exercise, so it can't separate their contributions. The authors explicitly propose a trial isolating exercise's added effect on remission, body composition, and fitness. Registration of such a trial would mark the next research step; results would tell clinicians whether the supervised training is essential or optional.

3

Guidelines adopt diet-plus-exercise for young adults

Possible Resolves by Oct 2, 2029

Discussed by: The paper argues the findings support re-evaluating treatment paradigms for early-onset type 2 diabetes as its prevalence rises.

If follow-up holds and replication succeeds, organizations like the American Diabetes Association or UK's NICE could add a structured diet-plus-exercise remission pathway for early-onset disease. That would shift practice from medication-first to lifestyle-first for eligible young adults. A guideline recommendation is the clearest marker of mainstream adoption.

Historical Context

3 moments from history that rhyme with this story — and how they unfolded.

July 2017 – 2019

DiRECT trial (2017–2019)

A UK primary-care trial led by Roy Taylor and Mike Lean had 298 adults with type 2 diabetes (average age 53) follow an 825–853 kcal/day diet with meal replacements for 3–5 months, then step food back in. Nearly half achieved remission at 12 months.

Then

About 9–10 kg average weight loss; 46% of the intervention group reached remission at 12 months and 36% at 24 months.

Now

Established that type 2 diabetes is reversible via substantial weight loss, overturning the 'progressive, incurable' framing and leading to national low-calorie diet rollouts.

Why this matters now

RESET applies the same diet logic to much younger patients (average 38) and adds supervised exercise, asking whether structured training adds remission and body-composition benefits.

2020 onward

NHS Type 2 Diabetes Path to Remission Programme (2020–)

England's health service began a national rollout of the low-calorie diet program based on DiRECT, offering around 900 kcal/day total diet replacement to people with type 2 diabetes and recent onset.

Then

Scaled the remission diet from a trial to thousands of patients through general practice referrals.

Now

Demonstrated that trial findings could become routine clinical policy within a few years.

Why this matters now

Shows the adoption path RESET's authors say they want; their paper explicitly calls for scalable, real-world implementation.

2001 – 2014

Look AHEAD trial (2001–2014)

A large US trial of intensive lifestyle intervention (calorie restriction plus exercise) in more than 5,000 adults with type 2 diabetes (average age about 59). It produced sustained weight loss and fitness gains but did not reach its primary goal of fewer cardiovascular events.

Then

Roughly 6% average weight loss maintained over years, with large improvements in fitness.

Now

Highlighted that lifestyle changes can alter body composition and fitness, but durability and hard clinical endpoints are hard to secure.

Why this matters now

Frames RESET's open question: will remission and heart benefits hold once the 24-week program ends?

Sources

(7)
+1
The Lancet Regional Health – Americas University of Leicester Medscape ScienceAlert Welltica LinkedIn (Kaberi Dasgupta) LinkedIn (keytohealth)