ImpaIred glucose regulation (IGR) is a risk factor for both developing diabetes mellitus and coronary heart disease (CHD) [1][2][3]. Based on World Health Organization (WHO) 1999 criteria for diabetes, the DECODE Study Group demonstrated that impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are both associated with an increased incidence of CHD and increased total mortality; and the multivariate-adjusted analysis showed that IGT is an indeFasting plasma glucose and 5-year incidence of diabetes in the JPHC diabetes study -suggestion for the threshold for impaired fasting glucose among Japanese To determine the optimal fasting plasma glucose (FPG) cut-off value which effectively identifies high risk subjects for type 2 diabetes in Japanese, we conducted a population-based prospective study on diabetes as part of the Japan Public Health Center-based Prospective Study and estimated the 5-year incidence of diabetes. The subjects of the analysis of this study were 2,207 Japanese aged 51-70 at baseline from whom a fasting blood sample was collected in both the baseline and the 5-year follow-up surveys and who completed the questionnaires at both times. Diabetes was defined as an FPG value ≥ 126 mg/dL (7.0 mmol/L) and/or self-reported diabetes. A total of 125 subjects developed diabetes during the 5 years after the baseline survey, and the incidence rate for a baseline FPG value of 95-99, 100-104, 105-109, 110-114, 115-119, and 120-125 mg/dL was 6.1, 11.5, 30.3, 52.6, 86.4, and 115.2 per 1,000 person-years, respectively. The results of receiver operating characteristic curve analysis suggested that an FPG value of 102 mg/dL (5.67 mmol/L) was optimal for predicting diabetes during the next 5-years. The cut-off value was similar in both genders and in the 51-to 60-year-old group and 61-to 70-year-old group. Use of hemoglobin A 1c level ≥ 6.1% for an additional diagnostic criterion resulted in a small increment in incidence, but the cut-off value for predicting diabetes was almost the same (101 mg/dL). The results of this study suggested that the cut-off FPG value should be lowered in terms of prediction of type 2 diabetes among Japanese populations.