Once considered a condition largely affecting middle-aged and older adults, type 2 diabetes is now rising markedly among people under the age of 40, with prevalence already exceeding 15 per cent in some countries, according to a new series of reports published in The Lancet. Globally, prevalence of type 2 diabetes in adults aged 20鈥39 years is estimated to have increased from 2.9 per cent (63 million people) in 2013 to 3.8 per cent (260 million people) in 2021, according to estimates cited in the report Managing early-onset type 2 diabetes in the individual and at the population level from the Series. The trend is worrying due to the lifetime risk it poses.The series argued that current strategies are falling short of meeting the needs of this younger population affected by early-onset type 2 diabetes. Type 1 diabetes is an autoimmune condition where the body鈥檚 immune system attacks insulin-producing cells in the pancreas, leading to little or no insulin production. Type 2 diabetes occurs when the body becomes resistant to insulin or doesn鈥檛 produce enough, often linked to lifestyle factors such as obesity and physical inactivity.The Lancet editorial introducing the series warned that early-onset type 2 diabetes presents unique and deeply concerning challenges for global health systems. The disease not only progresses more rapidly but also leads to multiple long-term conditions over the course of a patient鈥檚 life. The consequences are grave: Individuals diagnosed before the age of 30 lose, on average, 15 years of life expectancy. This is in addition to the strain placed on healthcare infrastructure and the disruption to individuals鈥 personal and economic lives, including their education, employment, and family planning.The rise in obesity prevalence is identified as a key driver of early-onset type 2 diabetes. In this context, the role of weight-focused interventions, particularly powerful incretin-based weight-loss drugs, has attracted increasing attention. While glucagon-like peptide-1 (GLP-1) receptor agonists appear safe and effective in children and adolescents, there is currently a lack of long-term outcome data. Furthermore, The Lancet noted that these drugs remain prohibitively expensive for many, especially in low- and middle-income countries undergoing demographic transitions.The editorial cautioned that an overreliance on these medications would risk deepening global health inequities. Access remains limited, and for many, these therapies are out of reach. As such, the authors assert that weight-loss drugs can only be part of the solution. The broader epidemiological picture is more complex. For example, body mass index (BMI), often used to assess diabetes risk, may not be a reliable indicator in all populations. Among south and east Asian groups, excess ectopic fat (stored in organs liver and pancreas) can occur even at lower BMI levels. In other settings, undernutrition during prenatal stages and early childhood plays a significant role in later diabetes development.Because of this diversity in risk profiles, the editorial calls for strategies that also include what are known as lean phenotypes (individuals who develop type 2 diabetes without being overweight). This underlines the need for more inclusive research agendas that consider different body types and metabolic responses across populations.The Lancet further argued that relying on treatment-based models alone fosters a reactive healthcare approach. Instead, prevention must be prioritised. The series highlighted the importance of starting early in life and confronting the obesogenic environments that contribute to rising diabetes prevalence. .Myriad societal factors contribute to obesity in children and adolescents, and global prevalence has increased by 244 per cent in the past 30 years.Editorial ‘Early-onset type 2 diabetes: no time for defeatism’, The Lancet.The complexity of the issue is immense. It is shaped by economic, cultural, social and environmental factors. But there are available solutions. The series highlighted examples where sustained public health action has yielded measurable benefits. One such intervention is the taxation of sugar-sweetened beverages, a policy endorsed by the World Health Organization and now adopted in more than 100 countries and territories.On average, such taxes have reduced sales of sugary drinks by 15 per cent globally. While measuring direct health outcomes remains a challenge, early findings suggest promising reductions in obesity rates, as well as dental caries.The Lancet also highlighted the findings of its second Commission on adolescent health, which identifies enabling legal and policy environments as critical for achieving long-term health improvements. Interventions must be structured not just around individuals, but around systems, addressing the broader contexts in which unhealthy behaviours are shaped.The editorial stressed that the world cannot afford complacency. The current scale and pace of early-onset type 2 diabetes represent not only a clinical crisis but also a social and generational one. Without a comprehensive rethinking of strategies, moving from prevention to treatment, from global equity to local action, millions of young lives may continue to be derailed just as they are beginning..Availability, affordability and targeted social media marketing of unhealthy food products have made them a prominent part of young people’s diets.Editorial ‘Early-onset type 2 diabetes: no time for defeatism’, The Lancet.Public health approaches must move upstream to conditions that cause obesity and promote healthy behaviours from early childhood.鈥淲ith millions of young people set to live longer with diabetes and its complications, the time to act is now,鈥 the authors of the editorial warned. Without urgent investment in prevention, early diagnosis and targeted care, health systems will face a mounting burden of multimorbidity and early-onset frailty.