Background: Diabetes mellitus (DM) is a chronic progressive disease that can lead to various complications in other organs and becoming a serious public health problem. This analysis aimed to determine the incidence of diabetes, pre-diabetes and risk factors that influence the occurrence of DM. Methods: Respondents who did not have DM at baseline Cohort Study of Non-Communicable Diseases in 2011 were followed until 2013. They were interviewed with questionnaires, had physical examination (measuring height, weight, waist circumference, blood pressure) and laboratory tests (fasting blood glucose, cholesterol, HDL, LDL and triglycerides) in accordance with procedures. Respondents were said to suffer from diabetes if the fasting blood glucose levels ≥ 126 mg/dL or blood glucose levels after loading 75 g glucose ≥ 200 mg/dL and was diagnosed diabetes by health professionals. Pre diabetes categorized into impaired fasting glucose (IFG) when fasting blood glucose levels (100–125 mg/dl) and impared glucose tolerance (IGT) when plasma glucose levels two hours after loading 75 g glucose 140–199 mg/dl. Result:Beseline respondents in 2011, was not suffering from diabetes and underwent a complete laboratory examination to follow-up in 2013 amounted to 1313 people. The incidence of diabetes is 3.5% and pre diabetes 18.4%. Multivariate logistic regression analysis demonstrated that central obesity (RR = 3.98; 95% CI: 1.86 to 8.55), Impaired Glucose Tolerance (RR = 3.49; 95% CI: 1.82 to 6.68), fasting blood sugar (RR = 3.35; 95% CI: 1.59 to 7.07), history of parental diabetes (RR = 2.41; 95% CI: 1.06 to 5.50), hypertension (RR = 1.88; 95% CI: 1.0 to 3.55) were risk factors that have a significant relationship with the occurrence of DM. Respondents with IFG and IGT has been changes into DM respectively by 13.5%; 10.4% after 2 years. Conclusion:the factor that most contribute to diabetes and IGT are central obesity, tasting blood glucose level, history of diabetes and hypertension. Recommendation:Prevention & promotion of diabetes risk should be done in the form of healthy behavior & wight loss.