# Nutrition-induced remission of type 2 diabetes: mechanisms, clinical evidence, and future directions-a mini review

## TL;DR

This review explores how specific nutrition strategies can lead to remission in type 2 diabetes, highlighting mechanisms and clinical outcomes.

## Contribution

The paper synthesizes recent evidence on nutritional interventions for T2DM remission and identifies gaps for future research.

## Key findings

- Nutritional interventions like low-energy diets and time-restricted eating can improve glycemic control and reduce ectopic fat.
- Remission is more likely with early diabetes onset, better initial glycemic status, and sustained weight loss.
- Meal timing and macronutrient quality influence the effectiveness of nutritional strategies.

## Abstract

Type 2 diabetes mellitus (T2DM) is considered a chronic, progressive and irreversible condition; however, evidence accumulated over the past decade demonstrates that remission of this disease can be achieved through targeted nutritional interventions. This mini review aims to synthesize current data regarding nutritional interventions that may lead to T2DM remission, with emphasis on the underlying mechanisms, clinical outcomes and implications for both research and clinical practice. Evidence supporting the role of structured dietary strategies, including low-energy diets, the Mediterranean dietary pattern, ketogenic approaches, and time-restricted eating, in improving glycemic control and facilitating remission is analyzed, mainly through the reduction of ectopic fat and the improvement of insulin sensitivity. Remission is more likely in individuals with a short duration of diabetes, a more favorable initial glycemic status, and significant and sustained weight loss, particularly when visceral and hepatic fat are reduced. Beyond weight loss, emerging data suggest that meal timing, macronutrient quality, and adherence to nutritional interventions play important modulatory roles. Despite promising results, current evidence is limited by heterogeneity in remission definitions, short follow-up periods, and difficulties related to implementation in real-world clinical practice and long-term sustainability. Nevertheless, there are insufficient data regarding predictors of relapse and the safety of nutritional interventions in vulnerable populations. In the future, research should prioritize long-term randomized studies primarily oriented toward remission and using personalized nutritional interventions. Therefore, nutrition-induced T2DM remission represents a feasible and clinically relevant therapeutic objective, with the potential to redefine current management strategies under the application of individualized, multidisciplinary, and long-term recommendations.