Within 20 years, the number of people in Australia with type 2 diabetes may increase from an estimated 870,000 in 2014 to over 2.5 million. 1 The care for these adults is predominantly provided by general practitioners. It is understandable that when a GP thinks diabetes, they think type 2 diabetes. Results from the 2007–2008 Australian National Children's Nutrition and Physical Activity Survey indicated that one in four children aged 5–17 years are now overweight or obese. 2 Yet the diabetes present in childhood, even in obese children, is overwhelmingly type 1. 3 Most of the care for children with diabetes, type 1 diabetes is provided by paediatric endocrinologists. It is understandable that when a GP thinks childhood diabetes, they think type 2 diabetes. The natural history of type 1 diabetes in childhood is progression from dysglycaemia to polyuria and polydipsia, with development of diabetic ketoacidosis if the diagnosis of diabetes mellitus is not made and appropriate treatment instituted. It is understandable that when a GP sees a child with polyuria and polydipsia, the GP thinks diabetes. The standard practise for diagnosing type 2 diabetes is lab measurement of fasting glucose, glucose tolerance test, or recently, glycated haemoglobin. The polyuria of developing diabetes can be interpreted as urinary frequency. Secondary enuresis is a common presentation in younger children. Both of these prompt consideration of urinary tract infection. Investigation of urine with microscopy, culture and sensitivity is the sensible next step. Laboratory medicine is essential to the diagnosis of diabetes. Its diagnostic criteria are laboratory based. Yet from work in Sydney, children who are given forms for lab-based testing present in DKA at a higher rate than children who have PoC testing done in the GP office, or are sent to hospital with no testing at all. 4 In Parma, across 8 years, the frequency of presentation of childhood diabetes in ketoacidosis dropped from 78% to 12.5%. 5 This was accomplished by focusing on diagnosis of diabetes in childhood before the presentation of ketoacidosis. In Australia today 40% of childhood diabetes presents in DKA. Our pathology services can improve that.