The coexistence of diabetes mellitus (DM) and SCA presents a complex and challenging medical scenario.[11] DM is a metabolic disorder characterized by elevated blood glucose levels due to insufficient insulin production or insulin resistance.[12–15] SCA, on the other hand, is a hereditary hemoglobinopathy that results in the formation of abnormal, crescent-shaped red blood cells, which can lead to a range of complications.[16]. This evidence concerns the gene INS and autosomal dominant cerebellar ataxia.