Type 2 Diabetes Remission Is Not a Theory.

Meta description: A major new trial shows diet and exercise can put early-onset type 2

diabetes into remission. A functional medicine practitioner explains what she sees in

practice, tracked with glucose and HbA1c, and how health coaching makes it last.

If you were diagnosed with type 2 diabetes in your 30s or 40s, you have probably been

told the same thing more than once: this is a lifelong condition, and the goal is to

manage it.

I understand why that message lands so heavily. You are young, you are busy, and you

were expecting decades of good health. Being handed a diagnosis with no way out

feels like a door closing.

Here is what I want you to know, and I say it as someone who works with this every

week: it is not always a closed door. In my clinic, I have supported many people to

reverse type 2 diabetes, and we have the numbers to show it, because we track

glucose and HbA1c closely from the first appointment onwards.

This month, a major trial presented at the European Association for the Study of

Diabetes (EASD) annual meeting and published in The Lancet added serious weight to

what many of us in practice have been seeing for years. Let me walk you through what

it found, what I see in my own work, and what it really takes to make remission last.

What the new research found

The RESET for Remission trial enrolled 96 adults with early-onset type 2 diabetes

(diagnosed at 45 or younger) and obesity, across three centres in England and Canada.

This group matters: early-onset type 2 diabetes tends to be more aggressive, with a

higher risk of complications, and has been under-represented in remission research.

Participants were either given usual care, or a 24-week programme of a low-calorie diet

(800 to 900 calories a day for the first 12 weeks) combined with supervised exercise,

half aerobic and half resistance training, followed by a weight-maintenance phase.

Physicians and dietitians monitored them throughout, and medications were stopped

under clinical supervision.

The result: 54% of the programme group reached remission at 24 weeks,

compared with 4% of those on usual care. Remission meant an HbA1c below 6.5%

with no glucose-lowering medication for at least 12 weeks.

The benefits went far beyond blood sugar. The programme group also saw:

 Greater fat loss, while muscle volume was preserved (confirmed by MRI)

 Improved insulin resistance

 Lower blood pressure, resting heart rate and triglycerides

 Less fat in the liver and pancreas

 Better strength and fitness

 Fewer depressive symptoms, less diabetes-related distress and a better quality

of life

No serious adverse events were reported.

Why this does not surprise me

When I read these findings, my first reaction was not surprise. It was recognition.

Type 2 diabetes is, at its core, a problem of how the body handles energy and responds

to insulin. When we address the drivers, including excess fat in the liver and pancreas,

loss of muscle quality, poor sleep, chronic stress, gut health and inflammation, the

system can recover. I see this in the data I collect with my clients: glucose readings that

settle, HbA1c that comes down, and medication that is no longer needed under their

doctor’s guidance.

Let me give you a real example, shared with permission and with identifying details

removed.

One of my clients came to me with an HbA1c of 48 mmol/mol, which is the threshold at

which type 2 diabetes is diagnosed. Over 12 months of working together, tracking their

results and adjusting the plan as their body responded, their HbA1c came down to 39

mmol/mol. That is not just below the diabetes threshold. It is below the prediabetes

range (42 to 47) and firmly in the normal range.

The number is only part of the story. Along the way, they lost weight, and they told me

something I hear again and again: they simply felt different. They had more energy. The

afternoon slumps eased, and they had the get-up-and-go to do things they had stopped

bothering with.

That is what happens when the body’s blood sugar regulation recovers. The change is

measurable on a lab report, and you feel it in your everyday life.

What the trial adds is something I value as a biomedical scientist: robust, randomised

evidence in a younger group, with imaging that shows what is actually happening in the

body.

The muscle point most people miss

Losing weight is not the goal. Losing the right kind of weight is.

Muscle is the largest site in your body for clearing glucose from the blood. When people

lose weight quickly through diet alone, they can lose muscle along with fat, and that

works against long-term metabolic health. In the trial, adding supervised exercise meant

that fat went down while muscle was protected and fitness improved.

One of the study’s authors noted that people with type 2 diabetes can show grip

strength and sit-to-stand performance typical of someone 10 to 20 years older, and a

two to four times greater risk of frailty and disability. That is why I treat strength and

movement as a core part of metabolic recovery, never an optional extra.

What the research also tells us, honestly

I always believe in giving you the full picture.

 It was a 24-week study. Weight regain after very low-calorie diets is well

documented. The experts commenting on the trial all stressed that a plan for

maintenance is essential.

 The support was intensive. Participants had regular clinical contact and

supervised exercise, and they said the social support was a big part of why it

worked. Reproducing that in a stretched healthcare system is hard.

 Motivation matters. As one of the professors put it, doctors can help, but the

individual has to want to be free of their diabetes.

 There was no diet-only comparison group, so we cannot yet separate exactly

what the exercise added.

One more point, and it is an important one for your safety. In the trial, medications were

stopped by the clinical team as part of a monitored protocol. Please never stop or

change diabetes or blood pressure medication on your own. Speak to your GP or

prescriber first. When I work with clients, I do so alongside their medical team.

There is also some genuine hope in the discussion: the longer you spend without type 2

diabetes, the lower your risk of heart and kidney complications. Every year counts.

Where health coaching makes the difference

Look closely at what worked in this trial and in my clinic, and it comes down to the same

ingredients: a clear plan, accurate data, regular accountability, and someone in

your corner.

That is exactly what most people are missing. You may have been given leaflets and

told to lose weight and move more. What you probably have not had is someone to turn

that advice into a plan that fits your life, check in when motivation dips, adjust when your

numbers tell a different story, and help you hold the gains for good.

That is what health coaching at Edinburgh Health is for.

Health coaching with us can help you to:

 Understand your own numbers. We track your glucose and HbA1c, and look at

the wider picture with advanced diagnostics, so your plan is built around your

biology and not a template.

 Build nutrition you can sustain. A realistic approach that works with your life,

your culture and your preferences, rather than a crash diet you cannot keep up.

 Protect your muscle and build strength. We find movement you will actually

do, and progress it safely.

 Address what sits underneath. Sleep, stress, gut health, hormones and

inflammation all affect blood sugar. My integrative approach, combining

biomedical science with Eastern medicine, acupuncture and lifestyle strategies,

connects the dots that are often treated in isolation.

 Stay accountable, without judgement. Regular check-ins, in person in

Edinburgh or remotely, so you are never doing this alone.

 Plan for the long term. The hardest part is not the first 12 weeks. It is month

nine, when life gets busy. We build the habits and safety nets that keep your

results in place.

Our coaching works alongside your GP and any treatment you are receiving. It does not

replace medical care.

I have been a clinician for over 20 years, and I have supported more than 3,000 people.

My own recovery from inflammatory bowel disease through an integrative approach

taught me firsthand that when conventional medicine draws a blank, digging deeper can

change the outcome. I bring that persistence to every client.

Is this for you?

Health coaching may be right for you if:

 You have type 2 diabetes or prediabetes and want to do more than “keep an eye

on it”

 You were diagnosed young and are worried about what the next 20 years look

like

 You have tried to improve your health before and found it hard to stay on track

alone

 You want a plan driven by your own data

 You want to feel stronger and have more energy, not just see a number change

on the scales

Take the first step

You do not need to have it all figured out. You just need a conversation.

Book a free 20-minute discovery call and we will talk about where you are, what you

want to change, and how coaching could help. No pressure, no obligation.

Book your discovery call at charmaine-shepherd.com

This article is for general information and is not a substitute for personal medical advice.

If you have type 2 diabetes or take medication for blood sugar or blood pressure, speak

to your GP or prescriber before changing your diet, exercise or medication. Very low-

calorie diets are not suitable for everyone. Individual results vary.

Source: Melville, N. A. “Low-Calorie Diet/Exercise Intervention May Drive Diabetes Into

Remission.” Medscape Medical News, 13 October 2026, reporting on the RESET for

Remission trial presented at EASD 2026 and published in The Lancet.

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