Type 2 Diabetes Remission: New Research Insights

Type 2 diabetes isn’t always a lifelong condition, nor does it have to worsen over time. Recent evidence suggests that individuals with prediabetes can lower their risk of developing this metabolic disorder by as much as 58 percent.

Diet and exercise play crucial roles in this. Researchers from the UK and Canada have discovered a method that successfully puts over half of patients with early-onset type 2 diabetes into remission. This approach combines a low-calorie diet with a structured exercise regimen.

“Our remission rates are among the highest reported in similar studies,” stated the team, led by Kaberi Dasgupta from McGill University in Canada. They believe these findings highlight the effectiveness of lifestyle changes in achieving meaningful remission.

They also note, for the first time, that such results can happen in a diverse population with early-onset type 2 diabetes through a combination of a low-energy diet and a well-organized exercise program.

Early-onset type 2 diabetes is typically diagnosed in individuals aged 45 or younger, and it often progresses more rapidly than cases identified later in life. Those with this condition frequently experience faster declines in their glucose levels and face higher risks of early health issues and mortality.

However, there are instances where positive changes are achievable. The study involved 96 participants from various ethnic backgrounds with early-onset type 2 diabetes who were not on insulin therapy. The average age of those involved was 38.

In the study, about half of the participants were instructed to maintain their usual routines, while the other half engaged in a low-energy diet and exercise intervention. Participants on the diet consumed around 800 to 900 calories daily and participated in supervised aerobic and resistance training sessions twice weekly, alongside independent workouts once a week.

Participant health was closely monitored throughout the trial. After 12 weeks of the intervention, they transitioned to a weight-maintenance diet and continued their independent exercise for another 12 weeks.

By the end of the 24-week study, remission was observed in 27 out of the 50 intervention group participants, while only two in the control group achieved remission—representing a remarkable difference of 50 percent, all without the use of glucose-lowering medications.

The intervention participants showed significant fat loss and, importantly, maintained their muscle mass and strength. By the trial’s conclusion, improvements in cardiovascular health were evident, including a 10.3 percent increase in respiratory fitness related to body mass, as well as reduced resting blood pressure and heart rate. Changes in the heart’s left ventricles also indicated better health compared to the control group.

Surveys revealed that participants felt less distressed by their diabetes and reported a better quality of life. The authors concluded that combining structured aerobic and resistance exercise with low-energy diets in those with early-onset type 2 diabetes is not only feasible but effective, potentially leading to significant health benefits alongside diabetes remission.

That said, since the trial lasted only 24 weeks, the longevity of these benefits remains uncertain. It’s also not clear which element—diet or exercise—was more influential.

While previous trials have explored how a low-energy diet can induce remission, placing too much focus on weight loss alone could result in muscle mass loss. Muscle is vital for metabolic health, acting as a primary site for glucose disposal and significantly impacting insulin response.

If excess fat accumulates in muscle, it may hinder insulin signaling, as some studies suggest. The authors recommend future research to compare participants on low-energy diets, exercise interventions, and combinations of both to assess their effects more fully.

They emphasize that preserving muscle while undergoing weight loss aimed at remission could have substantial implications for long-term metabolic health and overall physical function. This warrants examination in longer-term studies.

The findings have been published in The Lancet Regional Health – Americas.