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For most people living with type 2 diabetes, the condition is described as something to manage, not something that goes away. A new trial reported this week challenges that framing, at least for one group: younger adults whose diabetes began recently and who also live with obesity. After six months on a closely supervised low-calorie diet combined with regular exercise, more than half of them met the formal definition of remission, meaning their blood sugar had returned to a non-diabetic range without glucose-lowering medication.
The trial, called RESET for Remission, enrolled 96 adults aged 18 to 45 in England and Canada, working through teams at the University of Leicester, McGill University and the University of Alberta. None of the participants used insulin. Their average age was 38, and their average body mass index sat at 35.2, in the obesity range. Half were assigned to the intensive diet-and-exercise programme, and half continued with usual care. The results, presented at the annual meeting of the European Association for the Study of Diabetes and published in The Lancet Regional Health – Americas, are striking on their face: 27 of the 50 people in the intensive group, or 54 per cent, achieved remission, compared with 2 of the 46 people in usual care, about 4 per cent. After adjustment, the researchers reported that participants in the intensive group were 21 times more likely to reach remission.
That headline number deserves a slower read, because the trial was small, short and highly supervised. What makes it worth attention is not a promise but a pattern: a structured calorie deficit, paired with exercise and support, produced a result that usual care almost never did. This article walks through the 24 weeks as they actually unfolded, sets the two groups side by side, and separates what the trial proved from what it did not.
The 24 weeks, in three acts
The programme was not a single diet handed out on day one. It changed shape as the weeks passed, moving from a strict reset phase into ordinary food and then into maintenance. That staging matters, because it is also the part most often lost when a study like this is summarised in a headline.
Weeks 1–2: the reset
The intervention opened with an 800 to 900 calorie per day low-energy diet built around nutritional meal-replacement products. The macronutrient split was set at 30 per cent protein, 50 per cent carbohydrate and 20 per cent fat. At this level of intake, the diet is far below what most adults burn in a day, which is precisely why it was delivered inside a trial with medical supervision rather than as something to try alone. Participants also began supervised aerobic and resistance exercise twice a week, plus one independent session each week, a routine that continued through the first twelve weeks.
The logic of starting so low is familiar from earlier remission research: a large, rapid calorie deficit draws down fat stored in the liver and pancreas, and in some people that appears to restore the body’s ability to regulate blood sugar. The trial’s contribution is to test that idea specifically in younger adults, a group in whom type 2 diabetes is rising and in whom remission could, in principle, protect decades of health.
Weeks 3–12: one real meal a day
From the third week, the programme softened in one important way: participants began eating one conventional meal each day alongside the meal-replacement products. This is the phase where a diet stops being a formula and starts resembling real life again, with shopping, cooking and portion sizes re-entering the picture. Exercise stayed structured, with the same supervised sessions plus the weekly independent session.
This middle stretch is also where adherence usually decides a trial. A diet that works on paper but collapses in week five helps nobody, and the trial’s completion rate suggests the structure held: 86 of the 96 enrolled participants, about 90 per cent, completed their final assessments. That retention figure is part of the result, not a footnote to it, because a programme people abandon cannot produce remission at scale.
Weeks 13–24: holding the loss
The final twelve weeks shifted the goal from losing weight to keeping it off. Participants moved into a weight-loss maintenance phase, with the emphasis on sustaining the lower weight they had reached rather than pushing it further down. Remission was assessed at the end of this period, and the definition was strict: blood sugar, measured by HbA1c, below 6.5 per cent (48 mmol/mol), with no glucose-lowering medication for at least twelve weeks.
By that point, the weight gap between the groups was wide. Participants in the intensive group with weight data had lost an average of 8.4 kilograms, from 100.7 kilograms to 92.3 kilograms, compared with 1.2 kilograms in usual care. After adjustment, the difference was 7.5 kilograms more weight loss, including 6.6 kilograms more fat loss. The exercise component was designed with muscle preservation in mind, and resistance training was part of the supervised routine throughout the active phase.
Intervention vs usual care: the gap in one table
| Measure | Intensive diet + exercise | Usual care |
|---|---|---|
| Participants | 50 | 46 |
| Reached remission | 27 (54%) | 2 (about 4%) |
| Average weight lost | 8.4 kg | 1.2 kg |
| Daily intake in the reset phase | 800–900 calories | No set plan |
| Exercise | Supervised sessions twice weekly, plus one independent session | No programme |
The table is the story in miniature. Usual care, the standard support people ordinarily receive, almost never produced remission in this group over six months. The intensive programme did so for a majority. That contrast is why the trial is being described as a breakthrough, and it is also why the researchers are careful about its limits, which are covered below. The original report, carried by ScienceDaily from the European Association for the Study of Diabetes, sets out the full design, the participant profile and the complete results.
By the numbers
- 96 participants, aged 18 to 45, with early-onset type 2 diabetes and obesity, none using insulin.
- 54% remission in the intensive group (27 of 50), against about 4% with usual care (2 of 46).
- 800–900 calories per day during the reset phase, at 30% protein, 50% carbohydrate and 20% fat.
- 8.4 kg average weight loss in the intensive group, versus 1.2 kg with usual care.
- 90% completion, with 86 of 96 participants finishing final assessments.
- No severe adverse events were reported, though mild side effects were more common in the intensive group.
One number that should temper enthusiasm is the sample size itself. Ninety-six people is a small trial, and small trials can exaggerate effects. The researchers themselves note that longer studies are needed to learn whether the benefits last beyond six months. Remission at six months is a milestone, not a lifetime verdict.
Why younger adults, and why now
The trial’s age range is not incidental. Type 2 diabetes that begins before the age of 45 leaves a person facing decades of exposure to elevated blood sugar, and decades of exposure are what drive the complications people most fear: damage to eyes, kidneys, nerves and blood vessels that accumulates quietly over time. An intervention that can reverse the condition early therefore carries a different weight than the same result in someone diagnosed much later in life. It is not simply a better blood test; it is, potentially, a different trajectory.
That is also why the trial’s setting matters. The participants were recruited through centres in England and Canada, and the programme they received was intensive by design: structured products, a defined macronutrient split, supervised exercise and regular contact with the trial team. Usual care, by contrast, is what most people actually get — periodic appointments, general advice and medication adjusted over time. The trial does not suggest usual care is worthless; it shows that, for this group, it rarely produced remission on its own within six months. The policy question that follows is whether health systems can deliver something closer to the intensive programme at ordinary scale, and at what cost in staff time and support. That question is unanswered, and it is larger than any single trial.
Questions readers are asking
What exactly counts as remission in this trial?
Remission meant an HbA1c reading below 6.5 per cent, which sits under the threshold used to diagnose diabetes, together with no glucose-lowering medication for at least twelve weeks. It is a precise, checkable definition, and it is stricter than simply feeling better or losing weight.
Was this a diet-only result?
No. Exercise was built into the programme from the start, with supervised aerobic and resistance sessions twice a week and an independent session each week during the first twelve weeks. The trial tested a combined programme, so the results cannot be credited to the diet alone or to exercise alone.
Who was in the trial, and who was not?
Participants were adults aged 18 to 45 with early-onset type 2 diabetes and obesity, and none used insulin. The findings therefore speak most directly to younger adults with recently developed diabetes. They do not automatically extend to older adults, to people who have lived with diabetes for many years, or to people who use insulin.
Is an 800-calorie diet safe to try on your own?
The trial diet was medically supervised, with structured products, set macronutrients and professional oversight. A very low intake carries risks when unsupervised, and the trial reported more mild side effects in the intensive group. Anyone considering a major calorie reduction should discuss it with a clinician first rather than copying a trial protocol from a news report.
Does remission mean the diabetes is cured?
No. Remission means blood sugar is in the non-diabetic range without medication at the point it is measured. It can be lost if weight returns or blood sugar rises again, which is why the researchers stress the need for longer follow-up. The honest description is a reversal for now, with durability still unproven.
What the trial does not prove
Three cautions belong in any fair account of this study. First, duration: six months is long enough to show that remission is achievable, but not long enough to show that it holds. Weight regain is common after intensive programmes, and the trial’s maintenance phase was only twelve weeks. Second, scale: with 96 participants across centres in two countries, the result needs replication in larger, more diverse groups before it can guide routine care. Third, setting: this was a resource-intensive programme with meal replacements, supervised exercise and close monitoring. Whether the same outcome is reachable in ordinary clinics, without trial infrastructure, is an open question rather than a given.
None of that diminishes what was actually shown. For a group in whom remission was previously rare, a structured programme produced it in a majority within six months, with no severe adverse events reported. That is a meaningful signal, and it is the reason the findings were published in a peer-reviewed journal and presented at a major diabetes meeting rather than announced as a commercial claim.
What this means for someone counting calories
The trial is, at its core, a story about energy balance. A sustained calorie deficit, large enough to produce substantial fat loss and supported by exercise, changed a clinical outcome that medication alone had not. For readers who track their own intake, the useful lesson is structural rather than numerical: the deficit worked because it was planned, phased and supervised, with a maintenance stage built in from the start, not because a single dramatic week did the job.
Understanding your own daily energy needs is the starting point for any sensible conversation about intake, and a total daily energy expenditure estimate turns an abstract idea like a deficit into a concrete number. The TDEE calculator gives that estimate from age, height, weight and activity level, and it pairs naturally with the background in what TDEE actually measures and how calorie needs are calculated. For a step-by-step method, the guide to calculating TDEE walks through the same arithmetic the trial’s dietitians would have used as their starting point.
