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To determine the longitudinal relationship of muscle mass and strength with incident type 2 diabetes, and previously unstudied mediating effects of testosterone and inflammation.

Community-dwelling male participants (aged ≥ 35 years) of the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) Study underwent biomedical assessment in 2002–2006 and 2007–2010, including hand grip strength (dynamometer), testosterone and inflammatory markers. Body composition (dual-energy X-ray absorptiometry) was assessed at baseline only. Incident type 2 diabetes was defined as a self-reported doctor diagnosis, diabetes medication use, fasting plasma glucose ≥ 7.0 mmol/L, or glycated haemoglobin ≥ 6.5% (48 mmol/mol) at follow-up, that was not present at baseline.

Of n = 1632 men, incident type 2 diabetes occurred in 146 (8.9%). Muscle mass was not associated with …