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A combination of a low-calorie diet and structured exercise helped more than half of young adults with type 2 diabetes achieve remission within six months, compared with just 4 per cent of those receiving standard care, according to a new clinical trial.
The findings suggest that an intensive lifestyle intervention could offer a promising approach to managing early-onset type 2 diabetes, which is diagnosed in people under the age of 45.
The study was presented at the annual meeting of the European Association for the Study of Diabetes (EASD) and published in The Lancet Regional Health – Americas.
The research was conducted by a team led by Professor Kaberi Dasgupta, director of the Division of General Internal Medicine at McGill University in Montreal, Canada, and Professor Thomas Yates of the University of Leicester in the UK, alongside their colleagues.
Early-onset type 2 diabetes is often more aggressive than the condition diagnosed later in life, with patients facing a faster deterioration in blood sugar control, earlier complications and a shorter life expectancy.
Previous studies have found that very low-calorie diets can help some patients achieve remission. The latest trial examined whether adding structured exercise could improve the results while helping preserve muscle, improve cardiovascular fitness and reduce insulin resistance.
The randomised clinical trial was conducted at three research centres affiliated with the University of Leicester, McGill University and the University of Alberta in Edmonton, Canada.
It enrolled adults aged 18 to 45 with early-onset type 2 diabetes and obesity who were not using insulin.
Participants were randomly assigned to either standard medical care or an intensive lifestyle programme.
Those in the intervention group consumed 800 to 900 calories a day and undertook supervised aerobic and resistance exercise twice a week, alongside one independent exercise session weekly, during the first 12 weeks.
For the following 12 weeks, they transitioned to a diet designed to maintain their weight loss while continuing independent exercise.
Researchers assessed remission after 24 weeks. Participants were considered to be in remission if their HbA1c level was below 6.5 per cent, or 48 mmol/mol, and they had not taken glucose-lowering medication for at least 12 weeks.
HbA1c measures average blood glucose levels over approximately three months.
The researchers also examined changes in cardiovascular fitness, body composition and heart structure.
The findings highlight the potential of lifestyle-based interventions to alter the course of diabetes in younger adults, a group that may face decades of disease-related health risks.
However, remission does not mean diabetes has been permanently cured, and continued monitoring remains important.
The intensive calorie restriction used in the trial also requires medical supervision and should not be attempted without professional guidance.
