Introduction: Rapid increase in weight during early childhood, "catch-up growth" phenomenon, in children born small for gestational age (SGA) has been strongly linked with insulin resistance (IR), which may be a risk factor for type 2 diabetes mellitus and cardiovascular disease. IR occurred in the prenatal period has a protective role, that of intrauterine survival in conditions of malnutrition. In the postnatal period, early onset IR becomes a risk factor for metabolic syndrome and its components correlated with normal (or excessive) nutritional intake. Material and methods: A retrospective observational study was carried out on long-term metabolic complications in children born SGA, which were admitted to our hospital over a 5 year period from 2007 to 2011. 517 patients (mean age 12 years±0.6, aged between 6 - 18 years) were divided in two study groups, following the statistical processing of data sheets, as follows: 410 obese patients that were born appropriate for gestational age (AGA) (79,30 %) and 107 obese patients that were born SGA (29,69 %). Baseline glucose and insulin levels of the patients were measured and IR index was assessed by homeostasis model assessment (HOMA). A cut-off HOMA level of >2.5 in the prepubertal period and of > 3.5 for adolescents was used to identify an IR status. Results: IR was found in 20% of obese AGA children and 25,3% of obese SGA. Rate of IR in patients born SGA was greater compared to obese children born AGA and had a significant statistical difference (P = 0.03, mean 2,95229 AGA versus 3,72778 SGA group and SD 1,7 versus 2,6).Conclusion: Increased prevalence of IR patients born SGA compared to AGA indicates that being born SGA appears to be an additional risk factor in the developement of IR. IR met in a high percentage among obese patients born SGA, allows us to affirm that the cardiovascular risk in these patients as well as the risk of developing type 2 diabetes is higher. Monitoring, periodic evaluation and appropriate dietary therapy in the case of obese children born SGA is crucial in preventing early onset cardiovascular disease. [ABSTRACT FROM AUTHOR]