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Background: In recent decades, non-insulin dependent diabetes mellitus(NIDDM) became a major public health problem in Korea due to rapid economic growth. This study was performed to detemine the incidence of NIDDM in Yonchon County of Korea. Method: This study was performed as a prospective cohort study. We determined the 2-year incidence of NIDDM in 1193 Korean subjects who were found to be non-diabetic during the populationbased diabetes prevalence study in 1993 and also particiipated in the follow-up survey in 1995. Results: In two years, 67 subjects out of l193 non-dialbetic cohort developed diabetes, resulting in an annual rate of 2.8% as defined by World Health Organization criteria. After adjustment to the Korean stanchrd population as of 1990, the incidence rate became 2.5% per annum. The age-adjusted incidence was significantly higher in men than in women(6.4% vs. 3.0%, x =15.3, p<0.01). Subjects who converted to diabetes were older, more likely to be male, and had higher baseline fasting and 2 hour post-load glucose and triglyceride levels. Multiple logistic regression analysis revealed that age, male sex and baseline post-load plasma glucose concentrations are significant risk factors for the development of NIDDM. Conclusions: The incidence of NIDDM is much higher than expected and insulin resistance may not play an important role in this population. The reason far the rapid increase in the incidence should be further investigated.