Diabesity: an old term, a modern challenge — multi-omics and precision anti-obesity pharmacotherapy in type 2 diabetes
11 affiliations
- 1Department and Clinic of Internal Diseases and Metabolic Disorders, Poznan University of Medical Sciences , ,
- 2Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences , ,
- 3Health Care Complex in Ostrów Wielkopolski, Inpatient Treatment, Department of Internal Medicine – Ward B , ,
- 4Promise Department, School of Medicine, University of Palermo , ,
- 5Department of Pharmaceutical Chemistry, Ras Al Khaimah Medical and Health Sciences University , ,
- 6Department of Clinical Pharmacy and Pharmacology, RAK College of Pharmacy, RAK Medical and Health Sciences University , ,
- 7Department of Pharmacology, RAK College of Medical Sciences, RAK Medical and Health Sciences University , ,
- 8Department of Internal Medicine, RAK College of Medicine, RAK Medical and Health Sciences University , ,
- 9RAK College of Pharmacy, RAK Medical and Health Sciences University , ,
- 10Royal Cornwall Hospital, NHS Trust, Treliske , ,
- 11Department of Anatomy, Faculty of Medicine, Ovidius University , ,
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.
Related
- Precision Pharmacotherapy for Childhood Obesity: Molecular Targets Beyond Single GLP-1 Receptor Agonism and a Framework for Disease Modification
- ARF6: Biomarker, Therapeutic Target, and AI-Driven Precision Management for Type 2 Diabetes with Obesity
- Continuous glucose monitoring after discontinuation of incretin-based obesity pharmacotherapy: indirect evidence and a research framework for metabolic stability and weight maintenance
- Five-Year Glycemic Trends in a Remote Diabetes Management Program (RDMP): Contributions of Program Engagement and Evolving Pharmacotherapy Adoption and Adherence
- Do Gastric Balloons Have a Future? Intragastric Balloons in the Era of Highly Effective Obesity Pharmacotherapy.
BibTeX
@article{hoffmann2026diabesity,
title = {{Diabesity: an old term, a modern challenge — multi-omics and precision anti-obesity pharmacotherapy in type 2 diabetes}},
author = {Karolina Hoffmann and Weronika Faustyna Pucek and Wiktoria Skrzypek and Filip Kierzkowski and Piotr Ratajczak and Viviana Maggio and Manfredi Rizzo and Mohamed El-Tanani and Syed Arman Rabbani and Bhoomendra Bhongade and Shakta Mani Satyam and Sirajunisa Talath and Imran Rashid Rangraze and Adil Farooq Wali and Walaa Ibraheem and Yahia El-Tanani and Sorina Ispas and Wiesław Bryl and Anna Paczkowska},
journal = {Journal of pharmacy \& pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques},
year = {2026},
month = oct,
doi = {10.3389/jpps.2026.17560},
url = {https://europepmc.org/article/PMC/PMC13727511},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diabesity: an old term, a modern challenge — multi-omics and precision anti-obesity pharmacotherapy in type 2 diabetes
AU - Karolina Hoffmann
AU - Weronika Faustyna Pucek
AU - Wiktoria Skrzypek
AU - Filip Kierzkowski
AU - Piotr Ratajczak
AU - Viviana Maggio
AU - Manfredi Rizzo
AU - Mohamed El-Tanani
AU - Syed Arman Rabbani
AU - Bhoomendra Bhongade
AU - Shakta Mani Satyam
AU - Sirajunisa Talath
AU - Imran Rashid Rangraze
AU - Adil Farooq Wali
AU - Walaa Ibraheem
AU - Yahia El-Tanani
AU - Sorina Ispas
AU - Wiesław Bryl
AU - Anna Paczkowska
PY - 2026
DA - 2026/10/20
JO - Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques
DO - 10.3389/jpps.2026.17560
UR - https://europepmc.org/article/PMC/PMC13727511
AB - 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.
SN - 1482-1826
ER -