{
  "abstract": "Type 2 diabetes mellitus (T2DM) and obesity are closely interconnected but heterogeneous conditions in which treatment response, safety, body weight, glycemic control, and long-term clinical outcomes vary substantially between individuals. This narrative review evaluates emerging anti-obesity pharmacotherapy in patients with coexisting T2DM and obesity and examines the translational role of multi-omics in future precision treatment selection. Distinct from reviews focused primarily on obesity pharmacotherapy or omics-based disease stratification, the present review emphasizes the interface between contemporary drug mechanisms, T2DM-associated metabolic heterogeneity, candidate molecular signatures, and the level of evidence required for clinically actionable prescribing. We summarize evidence for approved and investigational oral incretin therapies, dual and triple receptor agonists, amylin-based strategies, established antidiabetic drugs, and adjunctive approaches targeting body composition. Throughout the review, we distinguish established clinical evidence from mechanistic rationale, candidate biomarkers, exploratory associations, and hypothetical future precision applications. We also separate metabolic efficacy endpoints, such as body weight and HbA1c, from intermediate cardiometabolic risk markers and from cardiovascular or kidney outcomes demonstrated in dedicated outcome trials. At present, no genomic, metabolomic, lipidomic, proteomic, microbiome, or integrated multi-omics signature has been clinically validated to select a specific anti-obesity medication for patients with T2DM and obesity. Major unresolved issues include the need for prospective biomarker validation, direct comparative trials, standardized assays, externally validated and calibrated prediction models, preservation of skeletal muscle health and physical function, long-term safety, treatment durability, affordability, and equitable implementation. Multi-omics should therefore be viewed as an investigational framework for generating and testing precision-treatment hypotheses rather than as a basis for routine prescribing.",
  "abstract_shown": true,
  "affiliations": [
    "Department and Clinic of Internal Diseases and Metabolic Disorders, Poznan University of Medical Sciences , ,",
    "Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences , ,",
    "Health Care Complex in Ostrów Wielkopolski, Inpatient Treatment, Department of Internal Medicine – Ward B , ,",
    "Promise Department, School of Medicine, University of Palermo , ,",
    "Department of Pharmaceutical Chemistry, Ras Al Khaimah Medical and Health Sciences University , ,",
    "Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University , ,",
    "Department of Pharmacology, RAK College of Medical Sciences, RAK Medical and Health Sciences University , ,",
    "Department of Internal Medicine, RAK College of Medicine, RAK Medical and Health Sciences University , ,",
    "RAK College of Pharmacy, RAK Medical and Health Sciences University , ,",
    "Royal Cornwall Hospital, NHS Trust, Treliske , ,",
    "Department of Anatomy, Faculty of Medicine, Ovidius University , ,"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 19,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Karolina Hoffmann"
    },
    {
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        1
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      "name": "Weronika Faustyna Pucek"
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    {
      "affs": [
        2
      ],
      "name": "Wiktoria Skrzypek"
    },
    {
      "affs": [
        2
      ],
      "name": "Filip Kierzkowski"
    },
    {
      "affs": [
        1
      ],
      "name": "Piotr Ratajczak"
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    {
      "affs": [
        3
      ],
      "name": "Viviana Maggio"
    },
    {
      "affs": [
        3
      ],
      "name": "Manfredi Rizzo"
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    {
      "affs": [
        4
      ],
      "name": "Mohamed El-Tanani"
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    {
      "affs": [
        5
      ],
      "name": "Syed Arman Rabbani"
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    {
      "affs": [
        4
      ],
      "name": "Bhoomendra Bhongade"
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    {
      "affs": [
        6
      ],
      "name": "Shakta Mani Satyam"
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    {
      "affs": [
        6
      ],
      "name": "Sirajunisa Talath"
    },
    {
      "affs": [
        7
      ],
      "name": "Imran Rashid Rangraze"
    },
    {
      "affs": [
        8
      ],
      "name": "Adil Farooq Wali"
    },
    {
      "affs": [
        4
      ],
      "name": "Walaa Ibraheem"
    },
    {
      "affs": [
        9
      ],
      "name": "Yahia El-Tanani"
    },
    {
      "affs": [
        10
      ],
      "name": "Sorina Ispas"
    },
    {
      "affs": [
        0
      ],
      "name": "Wiesław Bryl"
    },
    {
      "affs": [
        1
      ],
      "name": "Anna Paczkowska"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9g66ke2yercaw.bib",
  "cited_by": 0,
  "doi": "10.3389/jpps.2026.17560",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727511/?tool=EBI",
  "id": "9g66ke2yercaw",
  "issns": [
    "1482-1826"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727511",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
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      "openalex",
      "2712|Diabetes Treatment and Management"
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  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727511/pdf/?tool=EBI",
  "pmcid": "PMC13727511",
  "pmid": "42978695",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9g66ke2yercaw.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:46Z",
      "native_id": "PMC:PMC13727511",
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    {
      "first_seen": "2026-11-06T12:23:22Z",
      "native_id": "PMC13727511",
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      "url": "https://doi.org/10.3389/jpps.2026.17560"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetes Treatment and Management",
      "subfield": "endocrinology-metabolism"
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  ],
  "title": "Diabesity: an old term, a modern challenge — multi-omics and precision anti-obesity pharmacotherapy in type 2 diabetes",
  "title_text": "Diabesity: an old term, a modern challenge — multi-omics and precision anti-obesity pharmacotherapy in type 2 diabetes",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:41Z",
  "url": "https://research.draconitic.com/paper/9g66ke2yercaw",
  "venue": "Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques",
  "versions": []
}