New Trial: Diet and Exercise Reverse Early Type 2 Diabetes

A new clinical trial published this month has given fresh hope to people living with type 2 diabetes: more than half of participants put their condition into remission using a structured diet and exercise program — no medication required. It’s one of several remission breakthroughs reported in October 2026, alongside long-term surgery data and early Australian research.

The short version

• A UK trial called RESET for Remission found 54% of younger adults with early-onset type 2 diabetes achieved remission after 24 weeks of a supervised low-energy diet and exercise plan, compared with just 4% who had usual care.
• A long-term study of weight-loss (bariatric) surgery found 58% of people were still in remission after 11 years, versus 3% who had medical and lifestyle care alone.
• A new Australian study of bariatric surgery patients found remission rates of 37–67% at 12 months, depending on body size, but diabetes duration and starting HbA1c mattered more than weight alone.
• Remission is possible for some people, but it is not a cure — ongoing monitoring and, for many, long-term weight maintenance are essential.

What’s new this month

The headline study, known as RESET for Remission, was led by researchers at the University of Leicester and published in The Lancet in October 2026. It enrolled adults aged 18 to 45 with obesity and type 2 diabetes diagnosed relatively recently. Half were randomly assigned to 24 weeks of an 800–900 calorie-a-day meal replacement diet combined with supervised aerobic and resistance exercise; the rest received standard care.

Remission in the trial meant having an HbA1c (a blood test showing average blood glucose over roughly three months) below 6.5%, or 48 mmol/mol, for at least 12 weeks without needing glucose-lowering medicines. In the intervention group, 27 of 50 people (54%) reached this target, compared with just 2 of 46 (4%) in the usual-care group.

Separately, a long-term US study followed 262 people for a median of 11 years after either metabolic-bariatric surgery or standard medical and lifestyle management. Remission was far more common after surgery (58%) than with non-surgical care (3%). People were most likely to achieve lasting remission if they’d had diabetes for a shorter time, weren’t using insulin, were on fewer diabetes medicines, and lost more weight in the first year.

What the evidence shows

These findings build on earlier landmark research, including the UK’s DiRECT trial, which found about 46% of participants achieved remission at one year using a similar low-energy diet approach — though fewer maintained it at five years. The message across all this research is consistent: substantial, sustained weight loss, achieved either through intensive diet programs or surgery, is the strongest known lever for remission, and it works best when started earlier in the disease course, before the pancreas’s insulin-producing cells are too damaged.

Separately, early laboratory research from Cornell University, also reported in October 2026, identified cellular stress pathways that may contribute to the death of insulin-producing beta cells in the pancreas. Blocking parts of this pathway protected beta cells in mice and in human pancreatic tissue in the lab. This is promising but very early-stage — it’s not a treatment available to patients, and it may be years before (or if) it progresses to human trials.

Who this affects

This remission research applies specifically to type 2 diabetes, and mainly to adults with a relatively recent diagnosis who haven’t yet needed insulin. It does not apply to type 1 diabetes, which is an autoimmune condition without a remission pathway in the same sense, nor directly to gestational diabetes, though the broader principles around healthy weight and metabolic health remain relevant. People with prediabetes may also benefit from similar lifestyle approaches to prevent progression, though this wasn’t the focus of these particular studies.

What’s happening in Australia

An Australian study published in October 2026 in the journal Diabetic Medicine looked at remission after bariatric surgery at a tertiary hospital. At 12 months, 66.7% of patients with a very high BMI (45 or above) achieved remission, compared with 37.8% of those with lower BMI — though after adjusting for other factors, diabetes duration and baseline HbA1c were stronger predictors than BMI itself.

According to Diabetes Australia, remission should be understood as HbA1c below 6.5% maintained for at least three months without diabetes medication — and people in remission still need regular checks, typically HbA1c testing at least every six months, because relapse can happen. Structured low-energy diet programs and dietitian support are available through GP referral and the National Diabetes Services Scheme (NDSS), and bariatric surgery may be accessible through the public system or private health insurance for eligible patients, following assessment by an endocrinologist or surgical team.

What we still don’t know

These trials are encouraging, but important gaps remain. The RESET for Remission study only followed people for six months, so we don’t yet know how many will stay in remission long-term. Both the UK and Australian studies were relatively small. And as the DiRECT trial showed, remission often fades without continued weight maintenance — this isn’t a one-off fix.

What this means for you

If you’re living with type 2 diabetes and curious about remission, here are some safe next steps:

• Talk to your GP or endocrinologist about whether a supervised weight-management or diet program could suit your situation.
• Ask for a referral to an Accredited Practising Dietitian or credentialled diabetes educator through the NDSS.
• Never start a very-low-calorie diet or change your medicines on your own — this needs medical supervision, especially if you use insulin or sulfonylureas.
• Ask what monitoring you’d need if you did achieve remission, since ongoing HbA1c checks remain important.

Remission isn’t achievable or appropriate for everyone, and that’s okay — good diabetes management, whatever form it takes, is still a success. For more on eating well with diabetes, explore our daily menus and recipes elsewhere on Diabetes Clarity.