Type 2 diabetes in adolescents is reported to be increasing in prevalence. Its complications may occur dramatically earlier in patients who develop it during adolescence compared with the traditional patients who develop diabetes in middle age. It may be difficult to differentiate types of diabetes at the time of diagnosis; in this article, some helpful information will be presented to assist with that task and help with consideration of other types of diabetes. Lifestyle modification is the foundation treatment, as it is in adults with type 2 diabetes. Pharmaceutical treatment will be addressed.