EASD 2026: Half of young adults with T2D achieved remission with diet-plus-exercise program

Clinical takeaway: For adults diagnosed with type 2 diabetes before age 45, a low-energy diet combined with structured aerobic and resistance exercise led to diabetes remission in more than half of participants within 24 weeks. The approach also produced substantial weight loss and preserved muscle mass, with no severe safety concerns reported.

Early-onset type 2 diabetes (T2D) is an increasingly common and aggressive form of disease that is associated with faster loss of glycemic control, earlier complications, and shorter life expectancy than later-onset diabetes. While low-energy diets can induce remission, the added value of structured exercise, particularly for preserving muscle and improving overall cardiometabolic health, has remained uncertain.

In the RESET for Remission trial, researchers randomized 96 adults aged 18 to 45 years with early-onset T2D and obesity to either usual care or a 24-week intervention consisting of an 800-900 kcal/day low-energy diet plus supervised aerobic and resistance exercise. Participants in the intervention group stopped glucose-lowering medications at program initiation and transitioned from meal replacements to a structured maintenance phase with ongoing exercise.

At 24 weeks, diabetes remission, defined as HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks, was achieved by 54% of participants receiving the intervention compared with 4% of those receiving usual care. Intervention participants also lost an average of 8.4 kg, versus 1.2 kg in controls, and experienced substantially greater reductions in body fat.

Importantly, the weight loss strategy appeared to preserve muscle mass and improve measures of muscle quality, physical function, fitness, and cardiovascular health. No severe adverse events were reported. Most side effects were transient and related to the low-energy diet, including constipation, headache, dizziness, and fatigue.

The findings were presented at the 2026 EASD Annual Meeting and published in The Lancet Regional Health Americas. "Our findings demonstrate the feasibility and efficacy of combining structured aerobic and resistance exercise with a low energy diet in early onset type 2 diabetes," the investigators said, adding that the approach offers "substantial and holistic health and well-being benefits alongside diabetes remission."

Source: Dasgupta K, et al. (2026 Oct 1) Lancet Reg Health Am. RESET for Remission: low-energy diet plus structured exercise for remission of early-onset type 2 diabetes