Depression is highly prevalent among individuals with type 2 diabetes mellitus (T2DM) and is associated with poorer glycaemic control, reduced treatment adherence, increased complications, and diminished quality of life. Despite its significant impact, depression in T2DM often remains under recognized and undertreated, particularly in routine clinical practice where biomedical targets dominate care priorities. This keynote lecture highlights the bidirectional relationship between depression and T2DM and emphasizes the urgent need for compassionate, person-centred approaches to management. Compassionate care characterized by empathy, active listening, and respect for patients’ lived experiences can enhance engagement, reduce stigma, and foster therapeutic alliance, thereby improving both mental and metabolic outcomes. The lecture further explores the role of exercise therapy and lifestyle modification as evidence based, non pharmacological strategies that simultaneously address depressive symptoms and metabolic dysfunction. Regular physical activity, structured exercise programmes, and sustainable lifestyle changes have demonstrated benefits on mood, insulin sensitivity, and overall well being. Integrating compassion with exercise therapy and lifestyle modification offers a holistic, feasible, and scalable model of care for individuals with T2DM. This lecture advocates for interdisciplinary collaboration and the incorporation of mental health screening and compassionate communication into diabetes care to achieve optimal long-term outcomes.