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Aim: To present a patient with a diagnosis of Type 2 diabetes mellitus (T2DM) in childhood and to raise awareness of the increasing incidence of T2DM in the pediatric population and the importance of early detection and treatment. Case report: During the neurological treatment of a nine-year-old boy, it was found that the boy was overfed and had acanthosis on the neck. Laboratory tests revealed elevated liver enzymes, and ultrasound examination of the abdomen revealed diffuse echogenicity of the liver with homogeneous echoes. From the family history, it was learned that both parents suffer from T2DM, and the sister had gestational diabetes during pregnancy. Only two years later, the boy comes to see a gastroenterologist because of elevated liver enzymes. Due to obesity, he was referred to an endocrinologist. According to laboratory tests, he was admitted for newly diagnosed diabetes – fasting blood glucose was elevated (11.3 mmol/L) as well as glycosylated hemoglobin (HbA1c) (9.3%). They denied symptoms of polyuria, polydipsia and weight loss. Based on age, obesity, acanthosis and positive family history, a diagnosis of T2DM was made. Negative antibodies to T1DM – ICA (Islet cell antibodies), GAD (glutamic acid decarboxylase), IA2 (Islet antigen 2) – confirmed the diagnosis of T2DM. During hospitalization, hypertriglyceridemia and hypertension were diagnosed. Metformin therapy was introduced and the boy and his parents were educated about the importance of lifestyle changes, a balanced diet and daily physical activity. Metabolic control of the disease is poor, and check-ups are irregular. Conclusion: The differential diagnosis of T2DM should be considered in those children and adolescents with diabetes who are obese and have a positive family history of T2DM. The fact that these patients usually already have one or more comorbidities at the time of diagnosis can be helpful in making a diagnosis of T2DM. [ABSTRACT FROM AUTHOR]