The escalating diabetes pandemic poses a significant medical and societal challenge globally, with the Western Pacific Region (WPR) bearing the brunt. Currently, 206 million adults in the WPR live with diabetes, a number projected to soar to 260 million by 2045. Shockingly, diabetes accounted for 2.3 million deaths in the WPR in 2021, marking a historic high. Healthcare expenditure for diabetes in this region reached 241 billion USD in 2021, constituting 25% of the global spend on diabetes care. Given this trajectory, proactive prevention and disease management are paramount in the WPR. Crafting tailored treatment strategies for type 2 diabetes (T2D) in the WPR is intricate due to the disease's varied pathophysiology across diverse ethnicities and cultures. Significant differences exist in the role of β-cell dysfunction and insulin resistance among various ethnic groups, influenced by genetics, diet, and physical activity. Notably, east Asians predominantly exhibit T2D resulting from β-cell dysfunction, identifiable post-meal, paired with comparatively higher insulin sensitivity and lower obesity rates than Caucasians. Such pathophysiological insights have led to the prominence of incretin-based drugs like DPP-4 inhibitors and GLP-1 receptor agonists in the region, especially due to their efficacy in enhancing glucose-dependent insulin secretion. Concurrently, dietary interventions like the kaiseki, a traditional Japanese multi-course meal, have been demonstrated to counter post-meal glucose spikes, typical of β-cell dysfunction. SGLT2 inhibitors have been under the spotlight in the WPR, attributed to their cardiovascular, renal benefits, and potent effects on glucose control and weight management. These drugs function by facilitating urinary glucose excretion, resulting in improved glucose regulation and weight reduction. While real-world studies validate their efficacy in East Asians with T2D, it's crucial to exercise caution to avert potential ketoacidosis and sarcopenia, especially in those with β-cell dysfunction. In my presentation, I aim to elucidate the urgent need for personalized T2D treatment in the WPR, considering the region's intricate disease pathophysiology and cultural diversity. Moreover, I will stress the importance of fostering collaborations among medical professionals and researchers to advance diabetes care in the WPR.