This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The epidemic of obesity that has affected the entire population has not spared children and adolescents. In parallel with the increased prevalence in obesity, Type 2 diabetes has begun to be recognized in children and adolescents. Although we have long-experience in providing care for children with type 1 diabetes and adults with type 2 diabetes, there is little information regarding the means of providing care to achieve near-normal glycemia in children and adolescents with type 2 diabetes. The TODAY study is a multicenter clinical trial designed to examine several treatment options for the treatment of type 2 diabetes in children and adolescents. The study will recruit 10-17 year old children with diagnosed type 2 diabetes and randomly assign them to metformin plus a life-style intervention, troglitazone or placebo and determine the relative benefits of each in maintain in g long-term blood sugar levels as close to the non-diabetic range as possible.