Correspondence to:

Background: The global obesity epidemic has raised concerns about the risk of a tide of Type 2 diabetes (T2DM) in childhood. This paper aims to review the recent data on the epidemiology of this problem as well as the clinical concerns. Sources of data: A literature search was performed on Medline, and articles about childhood T2DM, in English and published from 2000 to 2008, were reviewed. Areas of agreement: A review of 16 paediatric studies suggest that although T2DM is now more widely reported in childhood, the numbers are still reasonably small although the data do suggest that ethnicity is an important risk factor. Areas of controversy: Although there are emerging data on what appears to be a significant risk of both microvascular and macrovascular complications in youth onset T2DM, the most appropriate management remains unclear. Currently, adult guidelines for management of T2DM are being extrapolated to the adolescent population with T2DM. Growing points: Studies are currently underway to examine the pharmacological management of childhood T2DM. Areas timely for developing research: More data are necessary on the exact prevalence of T2DM among a variety of populations to provide a greater understanding of the risk factors for T2DM and provide indications for screening. In the meantime, great emphasis needs to be placed on obesity prevention if we are to protect the health of future generations of children