Combined Diet and Structured Exercise Trial Shows Promising Remission Rates for Early-Onset Type 2 Diabetes
New research reveals that approximately half of early-onset type 2 diabetes cases can be reversed through a targeted regimen combining a low-energy diet with structured physical activity. The findings were presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Milan, Italy, and published in The Lancet Regional Health Americas journal.
Led by Professor Kaberi Dasgupta of McGill University and Professor Thomas Yates of the University of Leicester, alongside international colleagues, the investigation focused on early-onset type 2 diabetes (EOT2D). This specific clinical phenotype affects individuals under the age of 45 and is characterized by a rapid decline in blood sugar control, an earlier emergence of complications, and a reduced life expectancy compared to later-onset diagnoses.
While low-energy diets can successfully lower blood glucose levels below diagnostic thresholds without the use of medication—a state known as type 2 diabetes remission—incorporating structured exercise offers additional, synergistic advantages. These benefits include enhanced physical fitness, preservation of muscle mass, improved cardiac function, and reduced insulin resistance. To test these combined effects, researchers conducted a randomized, open-label trial across three medical centers in England and Canada, involving adults aged 18 to 45 with EOT2D and obesity who were not taking insulin.
Participants in the intervention group followed an intensive protocol. This began with an 800-to-900 calorie-per-day low-energy diet utilizing total meal replacements for the first two weeks, followed by calorie-controlled meal options up to week 12. Simultaneously, these participants engaged in twice-weekly supervised aerobic and resistance exercise sessions, supplemented by once-weekly independent workouts. From weeks 13 through 24, they transitioned to a weight-maintenance diet paired with independent exercise. The control group adhered strictly to usual care guidelines.
The primary endpoint measured remission at 24 weeks, defined by a glycated hemoglobin level below 6.5% while remaining entirely off glucose-lowering medication for at least 12 weeks. Out of 96 randomized participants, 86 completed the final assessments. The results demonstrated that 54% of participants in the intervention group achieved remission, compared to just 4% in the control group. Statistical adjustments indicated that individuals in the lifestyle intervention group were 21 times more likely to reach remission than those receiving standard care.
Furthermore, the intervention group experienced substantial fat loss while successfully mitigating muscle loss. Participants in the active lifestyle group lost an average of 8.4 kilograms over the 24-week period—roughly 7.5 kilograms more than the control group—which included 6.6 more kilograms of lost fat mass. Most adverse events reported in the intervention group were minor and typical of early low-energy diets, such as fatigue, headaches, or dizziness, and resolved over time without severe complications.
The study authors noted that while standard low-energy diets frequently result in the loss of both fat and muscle mass—potentially increasing long-term sarcopenia risk during weight regain—the incorporation of resistance training specifically targeted and preserved muscle tissue. Researchers emphasize that these integrated lifestyle interventions offer a holistic approach to managing the unique clinical challenges of early-onset type 2 diabetes, though further long-term, real-world evaluations are warranted.
Source: News-Medical.net
