Real-World and Clinical Implications of Patient Education, Lifestyle and Treatment Adherence in Romanian Diabetes Care: An Observational Study

<b>Background/Objectives:</b> Diabetes mellitus is a major global health concern requiring both preventive strategies and patient-centered clinical management. This study evaluated knowledge, lifestyle behaviors, treatment adherence and the use of digital tools among Romanian patients with diabetes in a real-world setting. <b>Methods:</b> A cross-sectional observational study was conducted on 100 patients recruited from community pharmacies in Iași, Romania. Data were collected using a structured 27-item questionnaire addressing demographics, disease management, adherence, lifestyle factors, and complications. <b>Results:</b> Most participants had type 2 diabetes. Engagement in healthy behaviors was suboptimal, with low levels of daily physical activity and limited routine glucose monitoring. Complications and treatment-related side effects were frequent, reflecting a high disease burden. Treatment adherence was significantly higher among younger patients, those with type 1 diabetes and individuals who had set long-term health goals. The use of digital technologies was low overall but more common in younger participants. <b>Conclusions:</b> This study identifies critical gaps in lifestyle practices, adherence and technology uptake among Romanian patients with diabetes. These findings carry important clinical implications, as poor adherence and limited self-management are closely linked to complications and higher healthcare spending. The findings suggest that patient education, integrating validated digital tools and enhancing the role of community healthcare providers could support better adherence and reduce long-term complications.