Diet and exercise program linked to diabetes remission in younger adults

In an open-label randomized trial of 96 adults aged 18–45 with obesity and early-onset type 2 diabetes, an intensive low-calorie diet and exercise program was compared with usual care. At 24 weeks, remission was recorded in 54% of the intervention group and 4% of the usual-care group; adverse events were more common with the intervention.

Remission at 24 weeks: 54% with intervention versus 4% with usual care.
Program combined an 800–900-calorie diet with structured exercise.
Adverse events were more frequent in the intervention group.
Small, open-label trial with 24-week follow-up.

The trial enrolled 96 adults aged 18–45 with obesity and type 2 diabetes who were not using insulin at three research centers in England and Canada. Participants were randomized to usual care or a 24-week lifestyle program: 800–900 calories daily plus supervised aerobic and resistance exercise twice weekly and one independent session weekly for 12 weeks, followed by a weight-maintenance diet and independent exercise. Remission was defined as HbA1c below 6.5% without glucose-lowering medication for at least 12 weeks.

At 24 weeks, 27 of 50 participants assigned to the program (54%) met the remission definition, compared with 2 of 46 (about 4%) receiving usual care. Mean weight loss was 8.4 kg among intervention participants with available data, versus 1.2 kg in the control group. No severe adverse events were reported, but at least one adverse event occurred in 43 of 50 intervention participants and 6 of 46 controls; reported symptoms included constipation, headache, dizziness and fatigue.

The findings support further evaluation of intensive lifestyle treatment for younger adults with obesity and early-onset type 2 diabetes, but do not establish long-term remission or durability of weight loss. The trial was open-label, included 96 participants and lasted 24 weeks. Medication withdrawal in the intervention group occurred under study medical supervision, so the results should not be taken as a basis for unsupervised medication changes.

In practice

For adults aged 18–45 with obesity and early-onset type 2 diabetes who were not using insulin, this small randomized trial found more 24-week remission with an intensive low-calorie diet plus structured exercise than with usual care (54% vs 4%). The result is promising but does not establish lasting remission or long-term safety: follow-up was 24 weeks, the trial was open-label, and adverse events were more frequent with the intervention. Medication changes occurred under study supervision; the findings do not support unsupervised medication withdrawal.

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Source

The Lancet Regional Health - Americas (via ScienceDaily): Type 2 diabetes breakthrough as 54% achieve remission in just 6 months ↗

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