RESET for Remission Trial (ScienceDaily)

ScienceDaily writeup (Oct 30 2026) of the RESET for Remission randomised, open-label, blinded-endpoint efficacy trial, published simultaneously in The Lancet Regional Health — Americas (DOI 10.1016/j.lana.2026.101664) and presented at the EASD annual meeting. First trial to test a combined low-calorie diet + supervised exercise program specifically in early-onset type 2 diabetes (EOT2D, under-45), in a multi-ethnic UK/Canada population.

Headline result

• 54% of the intervention group achieved Type 2 Diabetes Remission in 24 weeks vs 4% of usual-care controls — a 21× odds ratio after statistical adjustment.
• Remission defined as HbA1c < 6.5% (48 mmol/mol) and no glucose-lowering medication for at least 12 weeks.

Design

• N = 96 (50 intervention, 46 control), 40 UK + 56 Canada; aged 18–45; BMI mean 35.2 kg/m²; not on insulin; recruited Sep 2021–Jun 2025.
• Three centres: University of Leicester (UK), McGill (Montreal), University of Alberta (Edmonton).
• Lead investigators: Kaberi Dasgupta (McGill) and Thomas Yates (Leicester).
• Weeks 1–12: 800–900 kcal/day (30% protein / 50% carb / 20% fat); supervised aerobic + resistance exercise 2×/week plus 1 independent session; glucose- and BP-lowering meds discontinued at start (absent albuminuria). Weeks 1–2 all meals replaced with Optifast; weeks 3–12 one conventional meal/day permitted.
• Weeks 13–24: weight-maintenance diet, independent exercise.
• Open-label with blinded endpoint assessment. 86/96 (90%) completed final assessments. Missing remission data counted conservatively as non-remission.

Secondary findings

• Weight loss: intervention 100.7 → 92.3 kg (−8.4 kg); control 103.2 → 102.0 kg (−1.2 kg). Adjusted difference 7.5 kg.
• Fat-mass loss: intervention group lost an additional 6.6 kg of body fat vs controls — most of the weight delta is fat, not lean mass.
• Muscle preservation: fat-free mass largely preserved thanks to the resistance-training arm. The authors frame this as the trial's most durable contribution: prior very-low-calorie-diet remission protocols (e.g. DiRECT-era studies) left muscle vulnerable, raising long-term sarcopenia risk if weight is regained.
• Improvements also reported in cardiovascular fitness, muscle quality, heart structure, and patient-reported well-being.

Safety

• No severe adverse events.
• At least one adverse event in 43/50 intervention participants vs 6/46 controls — mostly early-phase constipation, headache, dizziness, fatigue; generally resolved.

Caveats the paper itself raises

• Remission ≠ cure. The threshold is HbA1c < 6.5% off meds; durability beyond 24 weeks was not measured here.
• Short follow-up. Longer studies needed to see how many participants hold weight loss, muscle mass, and remission after returning to everyday life outside clinical supervision.
• Open-label design. Participants and treating clinicians knew assignment — only outcome assessment was blinded.
• Small sample (N=96) for a trial making a 21× effect-size claim; the confidence interval around that odds ratio will be wide (the ScienceDaily writeup doesn't quote it).

Why it matters

Early-onset T2D is the aggressive form — faster β-cell decline, earlier complications, shorter life expectancy than later-onset — and its prevalence is rising globally. A six-month, drug-free protocol that puts most of this cohort into remission while preserving muscle is clinically meaningful even if durability is unproven. The authors flag pregnancy-planning populations as a specific use case (removes need for glucose-lowering drugs with pregnancy contraindications).

Journal reference

Dasgupta K, Boulé NG, Henson J, Redman E, et al. Low energy diet plus supervised exercise vs. usual care alone in people with early-onset type 2 diabetes (RESET for Remission): a randomised, open-label, blinded-endpoint efficacy trial. The Lancet Regional Health — Americas, 2026; 101664. DOI 10.1016/j.lana.2026.101664.

Capture context

Forwarded by the user via Telegram (Daily Learning msg #4432, 2026-11-01) with the instruction "save the key insights and supporting text from this paper into raw folder of my second brain." ScienceDaily is a secondary summary of a press release — treat the trial-design and effect-size numbers as reliable (they match the paper's own abstract framing) but note that no independent outlet is cited here.