In this episode, Dr. Tamara Hannon (Indiana University Health) and Prof. Martin Wabitsch (Universtätsklinikum Ulm) unpack the findings of the SURPASS-PEDS trial - the first study to evaluate the dual GIP/GLP-1 receptor agonist tirzepatide in adolescents with type 2 diabetes. With youth-onset type 2 diabetes rising sharply across the US and Europe, and with young people experiencing faster beta-cell decline, more severe obesity, and greater socioeconomic burdens, the need for effective therapies has never been greater. They discuss why adolescent disease differs fundamentally from adult type 2 diabetes, why weight-loss expectations cannot be compared across age groups, and how tirzepatide not only reduces HbA1c but also halts the extreme weight-gain velocity commonly seen in this population. They also reflect on what early intervention could mean for long-term metabolic health, how guidelines may evolve, and how better treatment options could transform quality of life for young people living with type 2 diabetes. This conversation highlights why youth-onset type 2 diabetes is fundamentally different from adult disease, why weight loss behaves differently in children, and how early intervention could change the life course for young people at high risk of long-term complications.