The integration of smart devices into chronic disease management has significantly shifted approaches in recent years. In the field of diabetes care, especially type 2 diabetes mellitus (T2DM), wearable device technology has enabled more responsive and personalized care solutions that can be scaled across diverse populations. Similarly, in obesity management— especially through smart rehabilitation programs—digital tools have enhanced patient engagement and facilitated sustained behavioral changes.

This narrative review, Progress in the management of type 2 diabetes mellitus: a narrative review of telerehabilitation and wearable devices, presents a comprehensive comparison of telerehabilitation and conventional rehabilitation models, with emphasis on the role of wearable devices [1]. The review evaluates multiple dimensions: accessibility, real-time monitoring, patient adherence, cost-effectiveness, and social support.

Wearable technology has proven to be an effective adjunct in both telerehabilitation and face-to-face rehabilitation programs. The integration of mobile health applications and wearable devices into diabetes management has been shown to enhance glycemic control, support physical activity engagement, and improve overall patient satisfaction, particularly among individuals with type 2 diabetes [2-4].

The clinical relevance of integrating wearable technologies is further highlighted when considered alongside foundational evidence in diabetes care. The UK Prospective Diabetes Study demonstrated the "legacy effect," where early and intensive glucose control led to long-term microvascular and macrovascular benefits [5]. These findings support the adoption of continuous and personalized interventions—precisely what digital rehabilitation tools offer.

Further reinforcing this perspective is the 2018 joint consensus report by major diabetes associations on self-management education and support, which outlined the importance of structured education and behavioral coaching [6]. The American Diabetes Association's 2024 Standards of Care advocate for digital health tools, including wearables and mobile apps, as key components of modern diabetes care [7].

In Korea, structural time constraints often limit the duration and depth of patient education. Additionally, patients with metabolically healthy obesity or prediabetes frequently fall outside of standardized care pathways due to the absence of clinically manifest disease. In such cases, where formal interventions may be delayed, telerehabilitation presents a timely opportunity for proactive engagement and behavior modification.

Importantly, the manuscript acknowledges that one size does not fit all. While telerehabilitation provides unmatched convenience and remote access—especially beneficial for patients in rural areas or with limited mobility—conventional rehabilitation offers face-to-face supervision and fosters stronger patient-provider relationships. Thus, the selection of intervention modality should be based on patient-specific needs, technology access, and personal preferences.

In conclusion, this review underscores the promising synergy between telerehabilitation, conventional rehabilitation, and wearable device technology in T2DM care. As the healthcare setting transitions toward personalized and technology-assisted models, hybrid approaches that appropriately incorporate both modalities are likely to achieve the best outcomes. Future research and policy should aim to enhance sustainability, address access inequalities, and ensure data security to support the broad adoption of these digital tools in diabetes care.