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New type 1 diabetes — SCE Endocrinology MCQ

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EasyDiabetesNew type 1 diabetesSCE Endocrinology

A 36-year-old man presents with weight loss, osmotic symptoms and ketonuria. HbA1c is 102 mmol/mol, random glucose 24 mmol/L and BMI is 22 kg/m2. His father developed type 2 diabetes aged 70 years. What is the most appropriate management?

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Correct answer: A — Treat as type 1 diabetes with basal-bolus insulin

The catabolic presentation with ketonuria should be treated as type 1 diabetes until proved otherwise. Delaying insulin for oral therapy risks diabetic ketoacidosis. A lean adult can still present with autoimmune diabetes, and treatment should not wait for antibody results.

Reference: NICE NG17; BNF