Insulin requiring diabetes mellitus (IRDM) is an uncommon form of diabetes seen in rural people with low –socio economic background in India. They present with very low BMI (< 18.5 kg/m2 ) with symptoms of severe weight loss and very high blood glucose. Despite very high blood glucose, they don’t develop diabetic ketoacidosis as we see in Type 1 Diabetes. They don’t respond to oral drugs & need insulin throughout their life. Secondary Diabetes also occurs due to pancreatitis either alcoholic & non-alcoholic. There are several reasons for pancreatitis like infection, smoking, auto- immune, alcoholism and gallstones, etc. Post pancreatitis diabetes may present with pancreatic calcification called as Fibro-Calculus Pancreatic Diabetes (FCPD).They also need insulin therapy. Secondary Diabetes Mellitus can also occur due to drugs like steroid therapy & drugs used in Oncology, HIV cases etc. People with few endocrine diseases can also develop secondary DM.