Diet plus supervised exercise put 27 of 50 people with early-onset type 2 diabetes into remission
Kaberi Dasgupta's McGill-led trial put 27 of 50 people with early-onset type 2 diabetes into remission with a low-calorie diet and supervised exercise. The authors call that rate high for similar trials, but follow-up ended at 24 weeks.
The Scientist · Science desk
27 of 50 participants in the intervention group were in remission at 24 weeks. Two participants in the control group entered remission. The trial included 96 participants at three centers in Canada and the UK.
| Figure | Value | Note | Claim |
|---|---|---|---|
| Intervention group in remission at 24 weeks, of 50 | 27 participants | 8 | |
| Control-group remissions | 2 participants | 9 | |
| Enrolled, three centers | 96 participants | 3 |
What happened
- The randomized trial enrolled 96 people with early-onset type 2 diabetes and obesity at three centers in Canada and the UK, none of them on insulin.
- The intervention arm ate roughly 800 to 900 calories a day and trained under supervision twice a week, with one more session a week on their own.
- In the comparison group, who carried on as normal, only two people entered remission.
- The intervention group lost substantial fat mass compared with the control group while preserving muscle mass and strength.
Why it matters
- What it limits constraint The comparison group got neither diet nor exercise, so the trial cannot say which component produced the remissions.
- Who's exposed exposure The result covers people with obesity who were not on insulin, so it says little about early-onset patients outside that profile.
- What's now possible capability Remission came without glucose-lowering medicine, in an early-onset form of the disease that tends to progress faster than later-onset cases.
ScienceAlert says two participants in the control group entered remission [9]. If all 96 participants were randomized and the intervention arm held 50 [3][8], the control arm held 46, and its remission rate was about 4 percent [24]. Against 54 percent in the intervention arm [23], that is a gap of about 50 percentage points [25]. ScienceAlert puts it at "a difference of 50 percent" [1]. With 50 people in an arm, one person moves the rate by two points [26].
The strict phase was short. Participants followed the diet and supervised sessions for 12 weeks, then moved to weight maintenance and independent exercise for 12 more [7]. Remission was counted at 24 weeks [8], so the count came 12 weeks after the 800 to 900 calorie diet ended [27][6].
The comparison group carried on as normal [5]. The authors suggest that future studies randomize participants to a low-energy diet, an exercise intervention, or both at once, so the three can be compared [18].
Muscle is the authors' particular interest. ScienceAlert notes that muscle is a primary site of glucose disposal and a major determinant of how the body responds to insulin [21], and that approaches focused solely on weight loss may risk losing it [22]. The team concludes: "Our findings indicate fat-free mass and muscle preservation is achievable with rapid weight loss" [20]. ScienceAlert also reports a 10.3 percent increase in respiratory fitness relative to body mass, with lower resting blood pressure and heart rate [12]. In surveys, participants reported less diabetes distress and a better quality of life [13].
Early-onset type 2 diabetes is often defined as a diagnosis at 45 or younger [19]. This group averaged 38 [4]. The authors write that the findings demonstrate "for the first time that such effects can be achieved in a multi-ethnic population with early onset type 2 diabetes through a combined low-energy diet and structured exercise intervention" [15]. They also wrote that their remission rates "are at the upper end of those previously reported in the literature for trials of similar duration" [14].
ScienceAlert's account does not include the glucose threshold used to define remission, or a breakdown of results by ethnicity. Without the threshold, a reader cannot check the comparison with other trials from this report.
We think 54 percent against about 4 percent is a credible signal that the package works in people like these. A 50-person arm leaves the size of the effect imprecise.
What to watch
- Follow-up data beyond 24 weeks showing whether the remissions hold.
- The three-way trial the authors propose, comparing diet alone, exercise alone and both together.
- The paper's remission threshold and any breakdown of results by ethnicity.
Clarity's read
What the record supports and how the coverage leans. The claims behind it follow.
Reality
- Evidence62
- Adoption
- Not scored
- Hype gap+20
- Incentives
- Not scored
- Confidence58
Claim ledger
Ranked by verification strength, evidence, and original report placement.
- [1]
ScienceAlert describes the gap between the intervention and control groups as "a difference of 50 percent."
- [2]
Researchers in the United Kingdom and Canada, led by Kaberi Dasgupta at McGill University, ran the trial of a low-calorie diet plus supervised exercise in early-onset type 2 diabetes.
- [3]
The randomized trial took place at three centers in Canada and the UK and included 96 participants of various ethnicities with early-onset type 2 diabetes and obesity, who were not on insulin therapy.
- [4]
The average age of the group was 38.
- [5]
Roughly half the group was randomized to continue their lives as normal, while the other half began a low-energy diet and exercise intervention.
- [6]
The diet involved roughly 800 to 900 calories a day; the exercise intervention was a twice-weekly supervised session of aerobic and resistance training plus a once-weekly independent exercise.
- [7]
After 12 weeks, participants switched to a weight-maintenance diet and continued exercising independently for a further 12 weeks.
- [8]
At 24 weeks, remission was achieved in 27 of 50 participants in the intervention group.
- [9]
Only two participants in the control group entered remission.
- [10]
The remissions were achieved without glucose-lowering medicine.
- [11]
Participants in the intervention group achieved substantial fat mass loss compared with the control group while preserving muscle mass and strength.
- [12]
By the end of the trial, cardiovascular health showed improvements including a 10.3 percent increase in respiratory fitness relative to body mass, and lower resting blood pressure and heart rate.
- [13]
In surveys, participants reported that their distress from diabetes had decreased and their quality of life had increased.
- [14]
The authors write: "Our remission rates are at the upper end of those previously reported in the literature for trials of similar duration."
- [15]
The authors write that the findings demonstrate "for the first time that such effects can be achieved in a multi-ethnic population with early onset type 2 diabetes through a combined low-energy diet and structured exercise intervention."
- [16]
The trial lasted only 24 weeks, so it is unclear how long the benefits might last.
- [17]
It is unclear whether diet or exercise played a larger role.
- [18]
The authors suggest that future studies randomize participants to receive a low-energy diet or an exercise intervention, as well as both at the same time, to compare the outcomes.
- [19]
Early-onset type 2 diabetes is often defined as a diagnosis at 45 years of age or younger, and it tends to progress more rapidly than cases that come on later in life.
- [20]
The team concludes: "Our findings indicate fat-free mass and muscle preservation is achievable with rapid weight loss."
- [21]
Muscle is a primary site of glucose disposal and a major determinant of how the body responds to insulin.
- [22]
Focusing solely on weight loss may risk a loss of muscle mass.
- [23]
Remission in the intervention arm was 54 percent (27 of 50).
- [24]
If all 96 participants were randomized and 50 were in the intervention arm, the control arm had 46 people, and 2 remissions is about 4 percent.
- [25]
The gap between the arms is about 50 percentage points.
- [26]
With 50 people in the intervention arm, each participant is worth two percentage points of remission rate.
- [27]
Remission was counted 12 weeks after the diet and supervised-exercise phase ended.
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Sources
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Entities
- Kaberi DasguptaFollow
- McGill UniversityFollow
- The Lancet Regional Health – AmericasFollow