This retrospective cohort study investigates the epidemiology of type 2 diabetes mellitus (T2DM) in adolescents in Kazakhstan from 2014 to 2021, focusing on incidence and all-cause hospital admissions. A cohort of 725 adolescents aged 10-17 years diagnosed with T2DM from 2014 to 2021 and registered in the Unified National Electronic Healthcare System (UNEHS) in Kazakhstan. Baseline demographic characteristics, incidence rates, and associated comorbidities and complications were analyzed. For the analysis of all-cause hospitalization rates, Cox regression modeling was used to assess the risk factors associated with hospitalizations, including demographic parameters and the presence of complications. The incidence of T2DM increased from 1.9 to 5.8 per 100,000 in the 10-13 age group and from 3.5 to 8.2 per 100,000 in the 14-17 age group. Girls had a higher incidence (3.0 to 7.3 per 100,000) compared to boys (2.5 to 6.5 per 100,000). The most common complications included retinopathy (14.62%), neuropathy (12.14%), and diabetic foot (6.62%). After diagnosis, 17.79% of patients were hospitalized due to all causes. Statistically significant risk factors for all-cause hospitalization included rural residence (HR: 1.51, 95% CI: 1.04-2.20), hypertension (HR: 1.99, 95% CI: 1.04-3.79), retinopathy (HR: 2.50, 95% CI: 1.56-4.02), and neuropathy (HR: 2.73, 95% CI: 1.06-2.83).