Two approaches—glargine followed by metformin and metformin alone—were investigated regarding their efficacy in preserving or improving β-cell function in youth with impaired glucose tolerance (IGT) or recently diagnosed type 2 diabetes during and after therapy withdrawal. The progressive deterioration of β-cell function was not halted among youth with IGT or recently diagnosed type 2 diabetes with either 3 months of glargine followed by 9 months of metformin or 12 months of metformin alone. Thereby suggesting the requirement for alternate approaches to preserve β-cell function in youth.