Is Diabetes Remission Really Possible?
More than 40 million Americans live with diabetes, and up to 95% of them have type 2 diabetes. While there is no cure, remission is possible—meaning blood sugar stays in a healthy range without medication. A new study published in The Lancet Regional Health found that 54% of people with early type 2 diabetes achieved remission through a combination of strict dieting and regular exercise.
How Was the Study Conducted?
Researchers recruited 96 participants aged 18 to 45, all diagnosed with obesity and early-onset type 2 diabetes (diagnosed before age 40, a form known to be more aggressive) within the prior six years, but not using insulin.
- Control group: continued usual diabetes care.
- Intervention group: followed a 12-week strict protocol—800 to 900 calories a day (about 30% protein, 50% carbohydrates, 20% fat), plus two supervised aerobic and resistance exercise sessions weekly, with a third session done on their own. They then transitioned to a weight-maintenance diet and exercised independently for another 12 weeks.
After 24 weeks, 27 of 50 participants (54%) in the intervention group achieved remission—A1C below 6.5% and sustained—compared with just 2 (4%) in the control group. The intervention group was 21 times more likely to achieve remission. They also lost an average of 18.5 pounds over 24 weeks, versus 2.6 pounds in the control group.
Why Does It Work? The Key Is Fat Loss With Muscle Preservation
Lead study author Dr. Kaberi Dasgupta, director of general internal medicine at McGill University, says remission largely comes down to weight loss—particularly fat loss. "A lot of the fat loss happens in the liver," she says. "Liver fat is a big factor in developing type 2 diabetes." Adding exercise matters too: "The exercise likely helps this to be fat loss and not muscle loss."
Registered dietitian Jessica Cording adds that significant weight loss can lower A1C, while preserving or building muscle through exercise supports blood sugar management and weight maintenance.
Experts Warn: The Extreme Approach Isn't for Everyone
Eating only 800 to 900 calories a day is extreme and typically not recommended outside of carefully supervised medical settings. The study also saw notable side effects: 86% of those on the protocol experienced significant adverse effects such as constipation, headache, dizziness, or cold sensitivity. And with only six months of follow-up, long-term results remain unclear.
Dr. Dasgupta says it's "conceivable" that similar results could be achieved with a less extreme diet. Cording suggests a gentler calorie reduction focused on adequate protein and fiber—both of which boost satiety—may take longer but be more comfortable and sustainable. "It doesn't typically work well in real life when people try to go really, really low on calories while also ramping up exercise," she says, adding that you don't have to give yourself just 24 weeks.
Practical Tips for Everyday People
- Don't attempt an 800-calorie very-low-calorie diet on your own—it requires medical supervision.
- Prioritize protein and fiber to help manage hunger.
- Combine aerobic and resistance training to lose fat while preserving muscle.
- Play the long game—gradual, steady changes are more sustainable than short bursts.
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