INS and diabetes mellitus: Reviewing all reported cases of diabetes mellitus in SDS patients, we hypothesize that SDS-associated diabetes can be divided into two groups: first, cases with a rather mild course of diabetes after manifestation in infancy or early childhood [17, 20, 21, 26], and second, cases in older children or adolescents that rapidly require intensive insulin therapy as in classic type 1 diabetes [13, 24].