Insulin-dependent diabetes mellitus (IDDM) is associated with neurological disorders. Sulph I, a monoclonal antibody to sulphatide (a neural epitope), stained secretory granules in alpha and beta cells of rat islets of Langerhans, but not exocrine tissue. Sera from 88% of 57 newly diagnosed IDDM patients was anti-sulphatide positive, and 76% were positive 6 months later. All 135 healthy controls were negative. Sulphatide antibody may be an IDDM marker.