Background: Conventional approaches for diabetes type-2 management generally fail to consider genetic and environmental variations for each patient. But new developments in personalized medicine and genetics are changing our understanding and approaches for type-2 treatment. Objective: To explore the effectiveness of a personalized medicine and genomic based interventions for glycemic level, medication compliance and complications in patients with diabetes type-2 compared to usual care. Methodology: A Randomized Controlled Trial (RCT) study was performed on total n=400 patients with type 2 diabetes. Patients were randomly assigned to two groups; the intervention group was treated according to genomic profile while the control group was treated in a routine manner. Glycemic control (HbA1c), treatment compliance, and the rate of complications during September 2023 till June 2024 were considered as primary indicators. An independent sample t-test and a chi-square test were used to analyse the results with the help of the SPSS version 27.0. p≤0.05 was considered statistically significant. Results: Those patients who were given individualized management had improved mean HbA1c level by 1 percent as compared to the initial level. 2% compared to 0.6% in the standard care group(p<0.01). Patients in the personalized care group had an 85% compliance to recommended treatment as opposed to the standard care group with only 65% (p<0.001). Also, the number of complications was much fewer in the personalized care group (10%) as compared to the standard care group (20%); (p= 0.02). Conclusion: Personalized medicine and genomics-based interventions offer substantial benefits in the management of Type 2 diabetes, leading to better blood sugar control, higher treatment adherence, and fewer complications. These findings suggest that integrating genomics into diabetes care could improve health outcomes for patients.