INS and Hyperglycemia: The recognition that adult black Americans with type 2 diabetes could present initially with diabetic ketoacidosis with no known precipitating cause (19 of 21 patients) was described by Banerji et al. [2•] under the rubric “Flatbush diabetes.” This syndrome was characterized by the acute onset of severe hyperglycemia with ketoacidosis requiring hospital admission and treatment with insulin and fluid and electrolyte replacement.