Indian Study Shows Type 2 Diabetes Remission May Be Possible without Surgery or Extreme Diets - Video

A new study published in the Indian Journal of Endocrinology and Metabolism is challenging long-held beliefs about type 2 diabetes mellitus (T2DM). The 'DiaRem-1' trial, conducted at a single center in India, shows that with a strategic combination of medication and lifestyle modifications, remission of T2DM may be possible.

The trial targeted adults diagnosed with T2DM within the past five years, with an HbA1c level below 8.5%. After an initial three-month period of medication, participants were taken off all antidiabetic drugs for another three months to assess for remission—defined in the study as maintaining an HbA1c level below 6.5% without any diabetes medication.

Participants were divided into two treatment arms. Fourteen patients in the intervention arm received a combination of liraglutide, dapagliflozin, and metformin. The control group of fifteen patients was treated with vildagliptin, glimepiride, and metformin. Both groups also received guidance on maintaining a home-based, healthy diet and daily physical activity, including brisk walking, yoga, or dancing.

At the end of the trial, 9 out of 29 participants (31%) achieved remission—four from the intervention group and five from the control group. "With early, intensive treatment and continued support, many patients may no longer need diabetes medication. That's a powerful message of hope," said Dr Rama Walia, lead investigator of the study, adding: "Physical workout for an hour daily, including brisk walk, yoga or dance, was advised in the trial. Patients were kept on a home-based healthy diet."

Significant weight loss was also observed, with the intervention group losing a median of 4.9 kg and the control group losing 3 kg. Both fat mass and body fat percentage decreased in both arms. No baseline characteristics could reliably predict who would go into remission, although shorter diabetes duration and greater weight loss appeared to favor success.

Unlike approaches that require strict diets or expensive surgeries, the DiaRem-1 trial presents a cost-effective, scalable model for outpatient clinics. The PGI team plans further research to determine how long remission lasts and whether longer treatment can improve results.

Reference: Sudhayakumar A, Arjunan D, Bhansali S, Bhujade H, Bhadada SK, Malhotra S, Walia R. Realisation of Remission of Diabetes Using Pharmacotherapy (DiaRem-1). Indian J Endocrinol Metab. 2025 Mar-Apr;29(2):217-223. doi: 10.4103/ijem.ijem_356_24. Epub 2025 Apr 29. PMID: 40416453; PMCID: PMC12101762.