Obesity is rife within the community, and associated conditions such as type 2 diabetes and cardiovascular disease threaten the future health of our children. While type 2 diabetes has been the focus of much media attention, type 1 diabetes mellitus remains the commonest form of newly diagnosed diabetes in childhood. This case study acts to remind practitioners that all young people (even those with established obesity) who present with symptoms, and/or biochemical derangements compatible with diabetes, should be managed acutely in order to avoid a delayed diagnosis of type 1 diabetes.