The recommendation to start insulin following metformin failure in children and adolescents contrasts with guidelines for adults with T2D, which recommend that other anti‐diabetes medications such as GLP‐1 RAs and sodium‐glucose co‐transporter‐2 inhibitors, many associated with weight loss or weight neutrality, can be started prior to insulin therapy, if medically appropriate.10, 43. The gene discussed is INS; the disease is type 2 diabetes mellitus.