Researchers at three centers in England and Canada report that a combined program of an 800–900 calorie daily diet and structured exercise put more than half of participants with early-onset type 2 diabetes into remission at 24 weeks.

In the RESET for Remission trial, 27 of 50 participants on the program — 54% — brought blood sugar below the diabetes diagnostic threshold without glucose-lowering medication, versus just 2 of 46 participants, or 4%, receiving usual care.

The trial, led by Professor Kaberi Dasgupta of McGill University and Professor Thomas Yates of the University of Leicester, was presented at the EASD 2026 Annual Meeting and published in The Lancet Regional Health – Americas.

Rapid weight loss typically strips away muscle along with fat, a trade-off that matters most in early-onset type 2 diabetes, a form diagnosed at 45 or younger that progresses aggressively and shortens life expectancy.

This trial, however, delivered fat loss while preserving lean mass: the intervention group lost an additional 7.5 kilograms versus usual care, including 6.6 kilograms more fat, with no significant differences in lean mass or muscle volume on MRI.

According to Medscape's report, co-author Tom Yates said imaging showed substantially less fat infiltration of muscle, and Karolinska Institutet's Juleen Zierath called the preserved skeletal muscle during substantial energy restriction striking.

The 96 participants, average age 38 with a mean BMI of 35.2, were randomly assigned between September 2021 and June 2025 and all had early-onset type 2 diabetes with obesity and were not taking insulin.

After statistical adjustment, those on the combined program were 21 times more likely to achieve remission than those on usual care, with remission defined as HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks.

Per Medscape, improvements also appeared in blood pressure, resting heart rate, triglycerides, liver fat, and handgrip strength, and 90% of participants attended final assessments.

Early-onset type 2 diabetes is a growing clinical population with elevated cardiovascular risk and poor long-term outcomes, and experts say current remission programs serve them poorly.

According to Medscape, Newcastle University's Roy Taylor, who led the landmark DIRECT trial, noted younger people in the NHS England remission program had lower remission rates than older patients, making a different approach necessary.

Dasgupta told Medscape the takeaway is that people with early-onset disease should ideally have a potent nondrug option — far less costly than metabolic surgery or lifelong GLP-1 medications — and that any year without type 2 diabetes lowers the risk of cardiovascular and kidney complications.

Key questions remain about whether the results translate beyond the trial.

Most intervention participants experienced adverse events such as constipation, headache, dizziness, and fatigue — all resolved, with no severe events reported — and SciTechDaily's coverage notes that weight regain after such diets commonly favors fat over muscle, raising sarcopenia risk over time.