A polymorphic locus flanking the 5' end of the insulin gene was studied in 154 unrelated Japanese diabetic and nondiabetic subjects. A predominance of the small allele was found with the following frequency: of 64 nondiabetic subjects, only 3 of 128 alleles were of the large class (2%); none of 78 alleles were of the large class in 39 Type 1 (insulin-dependent) diabetic subjects, and 4 of 102 alleles (4%) were of the large class in 51 Type 2 (non-insulin-dependent) diabetic subjects. The very low frequency of large allele may relate to the lower prevalence of atherosclerosis in Japanese. However, this possibility requires further examination.