Late onset type 1 diabetes

A 41 year old man from an Indian family whose father had type 2 diabetes presented to his general practitioner with a four week history of increasing thirst and polyuria. He had not noticed any weight loss. Blood tests were arranged to confirm the diagnosis of diabetes. One week later, after having to push his car home, he began to feel exhausted and developed intermittent vomiting, which he attributed to exertion. Over the next two days he became more unwell, and the out of hours primary care service was contacted. He was reviewed urgently and admitted with diabetic ketoacidosis.