There has been increasing recognition of an atypical entity of ketosis-prone diabetes, initially called Flatbush Diabetes, a heterogeneous syndrome characterised by patients initially developing diabetic ketoacidosis but who are then able to discontinue insulin therapy and remain in near-normoglycaemic remission, even without therapy, for months to years. The pathogenesis and if this atypical diabetes is a unique type of diabetes or a subset of more severe type 2 diabetes are unclear. A 47-year-old Colombian male was admitted with diabetic ketoacidosis in 2011. His blood glucose was 30mmol/L, ketones 3.6 mmol/L, bicarbonate 23 mmol/L and venous blood gas pH 7.25. Islet cell and GAD antibodies were negative. He was initially treated with insulin for a short period and then changed to metformin and gliclazide, with gliclazide subsequently ceased. He had excellent control of his diabetes with a HbA1c between 5-6%. In February 2020 he developed symptoms of hyperglycaemia, with pathology performed confirming an elevated BGL of 19.1 mmol/L, HbA1c of 13.3% and C-peptide of 0.2 nmol/L. He had no other significant medical history and reported no particular stressors. He was taking metformin 500mg BD. There was a positive family history of type 2 diabetes in his father. On assessment, his capillary BGLwas 16.5 mmol/L with ketones of 1.1 mmol/L. His weight was 72kgs and BMI 22.7. His abdomen was soft and non-tender. A CT of the chest, abdomen and pelvis revealed no evidence of a pancreatic lesion. Metformin was increased to 1000mg BD and he was commenced on basal bolus insulin. One month after initial review, glycaemic control had improved with only basal insulin required and metformin. This case demonstrates the importance of recognition of ketosis prone diabetes mellitus and its possible recurrence, which may have significant treatment and employment implications.