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The article analyzes trends in pharmacological management of pediatric patients with type 2 diabetes in German-speaking countries from 2000 to 2023 based on the Diabetes Prospective Follow-up Registry. The study shows changes in treatment regimens over the years, with an increase in the use of oral antidiabetic drugs (OADs) and glucagon-like peptide-1 receptor agonists (GLP1-RAs), and a decrease in insulin monotherapy or lifestyle intervention alone. Despite the availability of new treatment options, significant improvements in metabolic control and body mass index (BMI) are challenging to achieve in real-world settings. The study highlights the need for further research to determine the impact of expanded therapeutic options on pediatric patients with type 2 diabetes. [Extracted from the article]