Low-Calorie Diet Puts 54% of Young Adults Into Type 2 Diabetes Remission
12 November 2026, Montreal, CA: More than half of young adults with recently developed type 2 diabetes who followed a tightly supervised low-calorie diet and exercise programme were in remission six months later, compared with roughly one in 25 who received standard care, according to a randomized trial run in Canada and the United Kingdom.
The study, called RESET for Remission, enrolled 96 adults aged 18 to 45 with early-onset type 2 diabetes and obesity who were not using insulin. Their average age was 38 and their average body mass index (BMI, a weight-for-height measure) was 35.2, well inside the obese range. Fifty were assigned to the diet and exercise programme and 46 to usual care. After 24 weeks, 27 of the 50 in the intervention group (54%) met the trial’s definition of remission, against 2 of the 46 (about 4%) in the comparison group. After adjusting for differences between participants, the researchers put the odds of remission at about 21 times higher with the programme.
Remission was defined strictly: a glycated haemoglobin (HbA1c, a blood marker of average glucose over roughly three months) below 6.5%, the usual diagnostic threshold, with no glucose-lowering medication for at least 12 weeks. Participants with missing results were counted as not in remission, a cautious approach that avoids flattering the outcome. Assessors measuring the main outcome did not know which group participants were in, although participants themselves did, making it an open-label trial with blinded outcome assessment. The findings were reported by the European Association for the Study of Diabetes, where they were presented at its annual meeting, and published in The Lancet Regional Health, Americas.
The trial was led by Kaberi Dasgupta, director of the Division of General Internal Medicine at McGill University in Montreal, with Thomas Yates of the University of Leicester among the senior investigators. It ran at three centres, Leicester in England, McGill in Montreal and a site in Edmonton, Alberta, and enrolled participants between September 2021 and June 2025. Of the 96 randomized, 86 (90%) completed the final assessment.
How the programme worked
The intervention was demanding. For the first two weeks, participants replaced every meal with a formulated nutritional product, aiming for 800 to 900 kilocalories a day, roughly 30% from protein, 50% from carbohydrate and 20% from fat, and drinking at least two litres of calorie-free fluid daily. From weeks three to twelve they stayed at the same calorie ceiling but ate one ordinary meal a day, built around a protein target of 60 to 90 grams, a portion of fruit and two portions of non-starchy vegetables. The meal replacement used was Optifast in the UK and ProtiDiet in Canada. Supervised aerobic and resistance training took place twice a week with a third independent session, and the final twelve weeks switched to a weight-maintenance diet with exercise done independently.
Glucose-lowering drugs, and in most cases blood pressure drugs, were stopped under medical supervision at the start of the intensive phase. Blood pressure medicines were kept for participants with albuminuria, a sign of kidney stress.
Participants on the programme lost substantially more weight. Average weight in the intervention group fell from 100.7 kg to 92.3 kg, a drop of 8.4 kg, while the usual care group lost 1.2 kg. After adjustment, the programme produced about 7.5 kg more weight loss than usual care, of which about 6.6 kg was fat.
The approach carried more side effects. At least one adverse event was recorded in 43 of the 50 intervention participants against 6 of 46 in usual care, mostly constipation, headache, dizziness and fatigue in the early weeks, and these generally resolved. No severe adverse events were reported.
Unlike much of the current focus on weight-loss medicines, the programme used no such drugs, relying on calorie restriction delivered through formulated meal products and, later, ordinary foods. The trial measured outcomes only to 24 weeks, so it cannot show how long remission lasts.
The trial also reported secondary outcomes on muscle, body composition, cardiovascular markers and patient-reported wellbeing. The association’s summary does not disclose who funded the study or whether the makers of the meal replacements supplied product or had any role, and those details sit in the journal paper’s funding and competing interests statements.
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