In this study of treatments for recent-onset type 2 diabetes, metformin monotherapy was associated with durable glycemic control in about 50% of patients. The addition of rosiglitazone, but not intensive lifestyle intervention, to metformin was superior to metformin alone. Increases in childhood obesity have been accompanied by an increased incidence of type 2 diabetes in youth. 1 , 2 Because the risk of microvascular and macrovascular complications in adults increases with both the duration of diabetes and lack of glycemic control, 3 , 4 it is imperative to achieve and sustain metabolic control in youth. Addressing the physiological and psychological changes that normally occur during adolescence requires a high level of family involvement and makes the achievement of stringent treatment goals especially difficult in the case of adolescents with diabetes. 5 , 6 These challenges are heightened in disadvantaged populations, which are over-represented among adolescents . . .