A polymorphic region flanking the human insulin gene on the short arm of chromosome 11, the insulin-gene-linked DNA polymorphism, can be described as a locus with at least three classes of alleles: a common small “class 1” allele averaging 570 base pairs, a rare intermediate “class 2” allele of about 1320 base pairs, and a large “class 3” allele averaging 2470 base pairs in size.

We have determined the genotype at this locus of 393 unrelated diabetic and nondiabetic individuals. Differences were observed in the genotypie and allelic frequencies between groups of different races. Asians [17 nondiabetic, 2 with insulin-dependent diabetes mellitus (IDDM), and 8 with non-insulin-dependent diabetes mellitus (NIDDM)] exhibited the least variation in the size of this locus and 98% of the alleles in this group were class 1. A group of American blacks (32 nondiabetic, 5 with IDDM, and 40 with NIDDM) exhibited considerable variation in the size of this locus, and about 22% of the individuals examined had a genotype that included a rare class 2 allele. In neither of these two racial groups were the genotypie or allelic frequencies different between the nondiabetic and diabetic segments of these groups.

However, in a group of Caucasians (83 nondiabetic, 113 with IDDM, and 76 with NIDDM), there was a significantly higher frequency of class 1 alleles and genotypes containing two class 1 alleles in the diabetic patients compared with nondiabetic controls. A strikingly higher frequency of class 1 alleles (P < 0.0001) and genotypes containing two class 1 alleles (P < 0.0001) was observed in the IDDM group compared with nondiabetic Caucasians, whereas the difference between NIDDM and controls was only near the level of statistical significance (P = 0.025). Analysis of the combined data of our Caucasian population and those reported from studies of Caucasians from Denmark and St. Louis, Missouri, continued to show an increased frequency of class 1 alleles and genotypes containing two class 1 alleles in the IDDM group (P = 0.0001) compared with the nondiabetic group; however, there were no longer differences in genotypic or allelic frequencies between NIDDM and nondiabetic groups.