COMPREHENSIVE TREATMENT OF TYPE 2 DIABETES IN PATIENTS WITH OBESITY: THE ROLE OF PATIENT EDUCATION, WEIGHT REDUCTION, PHARMACOTHERAPY AND LIFESTYLE MODIFICATION - A NARRATIVE REVIEW

Type 2 diabetes and obesity are closely connected chronic conditions that require a comprehensive, patient-centred approach. Traditional management focused primarily on glycaemic control, whereas contemporary care increasingly recognizes weight reduction, cardiovascular-kidney-metabolic risk reduction and digital health tools as integral components of treatment. This narrative review synthesizes current evidence on the complex management of type 2 diabetes in adults with obesity, with emphasis on diabetes self-management education and support, intentional weight loss, lifestyle modification, pharmacotherapy and technology-enabled care. Publications were selected from PubMed-indexed literature, clinical guidelines, systematic reviews, meta-analyses and randomized controlled trials relevant to the intersection of diabetes, obesity, education, lifestyle and innovative health technologies. Education can improve glycaemic control and adherence. Structured weight-management interventions can support clinically meaningful weight loss and, in selected patients, remission of type 2 diabetes. Nutrition therapy and physical activity remain foundational, but their implementation requires individualized counselling, behavioural strategies and attention to social determinants of health. Pharmacotherapies such as metformin, sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors), glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) and dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists (dual GIP/GLP-1 receptor agonists) have shifted treatment from a purely glucose-centred model toward weight-centred. Digital health applications, wearable devices and continuous glucose monitoring may strengthen education and self-management, although equity and long-term engagement remain. Integrated care models combining education, weight management, pharmacotherapy and digital follow-up are likely to produce the greatest clinical and public health benefit.