The increase in the prevalence of obesity has contributed to the increased incidence of prediabetes and type 2 diabetes mellitus among youth and adults. Progressive decline in ß-cell function is now well recognized in children and adults to be pivotal in the progression from normal to abnormal glucose tolerance. Given the increased recognition of the critical role of the ß-cell in the pathogenesis of type 2 diabetes, efforts have begun to shift to prevention of the loss of insulin secretion among individuals at high risk for type 2 diabetes or early stages of the disease. RISE is determining whether medication or surgical intervention strategies can mitigate progressive ß-cell dysfunction in adults and youth with prediabetes or early type 2 diabetes.