A strict routine combining a low-calorie diet with supervised strength and aerobic training helped more than half of younger adults reverse type 2 diabetes within six months, according to a study published in The Lancet Regional Health - Americas.
The study, dubbed the RESET for Remission trial, found that 54% of participants under age 45 who completed the intensive lifestyle program achieved disease remission.
In comparison, only 4% of participants receiving standard medical care reached the same milestone.
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Type 2 diabetes diagnosed at a younger age is historically aggressive, according to medical literature.
Patients diagnosed before 45 face a faster loss of blood sugar control, earlier cardiovascular complications and a shorter overall life expectancy than those diagnosed later in life.
Researchers from McGill University in Canada and the University of Leicester in the United Kingdom enrolled 96 adults between the ages of 18 and 45 who were living with obesity and early-onset type 2 diabetes. None of the participants were using insulin.
The intervention group halted their blood sugar and blood pressure medications under medical supervision and began an intensive 800- to 900-calorie daily diet.
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For the first two weeks, patients consumed only meal-replacement products. From weeks three through 12, they were allowed one structured meal of lean protein and vegetables each day alongside meal replacements, before shifting into a weight maintenance phase for the final 12 weeks.
The program paired calorie restriction with supervised aerobic and resistance training twice weekly, plus one weekly solo workout.
"Our study shows that it is possible to combine a low-calorie diet with supervised exercise in young adults with type 2 diabetes," lead author Dr. Kaberi Dasgupta, a professor of medicine and director of the Division of General Internal Medicine at McGill University, told Fox News Digital.
"There has previously been some concern about combining the two as being too much of a burden for people. However, people in our study stayed in our study."
Only 10% of participants failed to complete the final evaluations, and patients attended a median of 17 out of 20 scheduled supervised gym sessions.
The researchers emphasized resistance training to combat the loss of lean muscle mass, a major risk associated with rapid weight loss.
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People who lose weight through crash dieting or appetite-suppressing medications may shed muscle along with fat, experts warn. If the weight returns, some research suggests it may come back disproportionately as body fat, potentially affecting muscle health and metabolism over time.
"In our study, we think the diet provoked the weight loss, and exercise helped make sure it was [not] from muscle," Dasgupta said.
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"We were happy and surprised that not only did people lose fat from their organs and liver, our MRI studies indicated their muscle did not decrease at all and their handgrip strength went up."
Participants shed an average of 18.5 pounds over 24 weeks, while significantly boosting their treadmill endurance and overall cardiovascular fitness.
To meet the official standard for remission, patients had to maintain an HbA1c blood sugar level below 6.5% after going at least 12 weeks without any glucose-lowering drugs.
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After accounting for baseline health factors, researchers concluded that patients on the diet and exercise program were 21 times more likely to achieve remission than those receiving routine care.
Despite the promising outcomes, experts emphasized notable limitations. The trial was small, examining fewer than 100 individuals across medical centers in England and Canada over a relatively short six-month window.
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Dasgupta also noted that the study could not determine exactly what was responsible for each benefit.
"The main limitation is that we had to compare the diet plus exercise with usual care," he told Fox News Digital. "We would have liked to compare diet alone against diet and exercise to perfectly prove the point that the improvements in muscle and fitness were from the exercise."
The strict routine also took a physical toll. Roughly 86% of the intervention group reported mild to moderate side effects, primarily during the early weeks, including headaches, fatigue, dizziness and constipation, though researchers noted that no severe medical complications occurred.
Health professionals cautioned that diabetes remission is not a permanent cure, and sustaining an 800-calorie threshold alongside supervised gym can present steep hurdles for busy adults outside a clinical setting.
Study authors noted that longer-term trials in real-world settings are still needed to determine whether patients can keep the weight off, preserve their muscle gains and remain medication-free once regular daily routines resume.