en تخصصي Special پژوهشي Research <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span calibri="" style="font-family:"><span style="font-size:10.5pt"><span new="" roman="" style="font-family:" times="">As diabetes mellitus evolves into a global health crisis, conventional diagnostic and therapeutic paradigms are no longer sufficient and necessitate innovative treatment approaches that extend beyond traditional pharmacotherapy. Recent advances in epigenetics have uncovered heritable and reversible changes in gene regulation that contribute to the pathogenesis of diabetes.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span calibri="" style="font-family:"><span style="font-size:10.5pt"><span new="" roman="" style="font-family:" times="">This review provides a comprehensive analysis of various epigenetic mechanisms, including DNA methylation, histone modifications, and the role of non-coding RNAs in diabetes development, and evaluates their integration into a precision medicine framework for early diagnosis, risk stratification, and biomarker-guided therapeutic interventions. Furthermore, we discuss personalized management strategies that leverage epigenetic understanding to optimize therapeutic and preventive outcomes. Finally, we consider the upcoming obstacles and prospective scope of personalized medicine in the field of diabetes management. Incorporating epigenetic profiling into diagnostic and therapeutic workflows enables higher-resolution risk assessment, precision targeting of interventions, and improved pharmacodynamic outcomes. Epigenetically informed strategies, including HDAC inhibitors, DNMT modulators, and microbiota-driven interventions, hold promise for enhancing therapeutic efficacy, optimizing drug selection, and personalizing lifestyle interventions.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span calibri="" style="font-family:"><span style="font-size:10.5pt"><span new="" roman="" style="font-family:" times="">While translational challenges remain, this review highlights that the integration of epigenetic data with genomics, metabolomics, and microbiomics facilitates next-generation personalized diabetes care and has the potential to reshape both clinical practice and public health strategies in the fight against diabetes</span></span><span lang="EN-GB" style="font-size:10.5pt"><span new="" roman="" style="font-family:" times="">.</span></span><span style="font-size:10.5pt"><span style="font-family:"Times New Roman",serif"></span></span></span></span></span></span><br> &nbsp; Diabetes mellitus, Epigenomics, Precision medicine, Multiomics 227 238 http://ijdo.ssu.ac.ir/browse.php?a_code=A-10-30-491&slc_lang=en&sid=1 Alireza Abbasi-Bafetrat 0009-0004-0285-4613 Yes Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran. Mohammad Abbasi-Bafetrat 0009-0006-7169-7396 No Department of Education, Faculty of Biology, Farhangian University, Shahrekord, Iran.