The theme for both 2007 and 2008 is “Diabetes and Children and Adolescents,” indicating that diabetes in children and adolescents has become a serious global public health problem. Diabetes in children and adolescents has become a serious global public health problem. In recent years, there has been an increase in the number of innocent and young faces among the mainly middle-aged and elderly population with type 2 diabetes. According to a Japanese report, the incidence of type 2 diabetes among school-age children has increased 30-fold in the last 20 years, and 80% of them are caused by obesity. Among the diabetic children hospitalized in the endocrinology department of Zhengzhou Children’s Hospital, there were 5 cases of type 2 diabetes from 1994 to 2004, accounting for 3% of the newly diagnosed diabetes in the same period; from 2004 to 2009, there were 20 cases, accounting for 11%, and the average age of these children was 12.5 years old, and all of them were moderately obese children. It can be said that obese children are the reserve army of type 2 diabetes. According to incomplete statistics, the proportion of obesity among school children aged 6 to 18 years old in the world is 10%. In China’s urban children, the growth rate of small fat pier has greatly exceeded that of Europe and the United States and other developed countries, obese children have accounted for 11% of the total number of children in the country. A large number of obese children have become the “reserve army” of type 2 diabetes, and some of them have become “active duty” personnel. The earlier the age of diabetes, the younger the age at which various chronic complications will occur. Chronic complications include diabetic retinopathy, diabetic nephropathy, diabetic foot, etc., and generally occur within 10 to 20 years. Assuming that a person develops diabetes at age 60, he may develop complications at age 70 to 80, and the time for complications to affect his life is relatively short. A 10-year-old child with diabetes may have complications at the age of 20 to 30, then the rest of the child’s life will be unthinkable, and the complications will gradually worsen with the prolongation of the disease, thus seriously affecting the quality of life of the patient and bringing heavy economic burden and mental pressure to the patient and the family. However, some parents still have a variety of misconceptions about their children’s obesity: some think that the child is chubby and cute; some people are proud of having a “fat boy” and are happy about it, and do not pay due attention to it; some have an indifferent attitude and think that they will be slimmer with the growth of age and height. Although some parents have recognized that obesity leads to a greatly increased risk of a variety of diseases, but often think that it is someone else’s children’s business, will not fall on their own head. As a result, very few children come to the doctor just because they are obese, and at least 70% of children with obesity do not visit a regular hospital in a timely manner. So why are obese children susceptible to diabetes? It starts with insulin. Insulin is secreted by the pancreatic beta cells of the human pancreas and is the only blood sugar-lowering hormone in the body. If the amount of insulin secreted by the body is insufficient or the secreted insulin cannot play its normal physiological role, it can cause blood sugar to rise and even diabetes. Obese people have insulin resistance, the body’s insulin can not play the role of normal people to lower blood sugar, so the efficiency of the role of insulin is reduced, then the pancreatic beta cells need to work overload, secrete more insulin to keep the body’s blood sugar in the normal range. This will eventually lead to fatigue of the pancreatic beta cells, the ability to secrete insulin gradually weakened or even failure, and eventually diabetes occurs. Here to remind parents, if the fat child’s neck, armpits, groin skin color darkened, similar to not washed “old mud”, this phenomenon in medical terms is called “black acanthosis sign”, may be the early manifestation of diabetes. It can be said to be an early warning sign of abnormal glucose tolerance in obese children, which should be taken seriously and the function of pancreatic islet cells should be checked at the Department of Pediatric Endocrinology of regular hospitals as soon as possible. To prevent and treat type 2 diabetes in children, we should develop good lifestyle habits, including a balanced diet, reasonable exercise, and abstain from overeating. Parents of overweight or obese children, especially those with a family history of diabetes, hypertension and coronary heart disease, should be highly concerned and go to a regular pediatric endocrinology department for relevant examinations and medical interventions as soon as possible. If treatment is given during the pre-diabetic period, i.e. insulin resistance, pancreatic islet function can be restored to normal, while once diabetes develops, not only do they have to deal with the medicine jar for the rest of their lives, but the chronic complications mentioned above will inevitably appear several years later.