Thiamine responsive megaloblastic anemia (TRMA) is an autosomal recessive disorder, which is caused by loss of function mutations in the SLC19A2 gene. TRMA is characterized by anemia, deafness, and diabetes mellitus. We now report two sisters, the eldest of which presented to a different hospital during childhood with sensorineural deafness, which was treated with a hearing prosthesis, insulin requiring diabetes, megaloblastic anemia. The younger sister is also affected with sensorineural deafness along with diabetes and megaloblastic anemia. Because a diagnosis of TRMA was suspected, therapy with insulin and thiamine was started to which the child is responding. Diabetes associated with deafness and megaloblastic anemia, suggests a diagnosis of TRMA.