Ramezankhani A, et al. - Among Iranian adults in whom type 2 diabetes did and did not develop, researchers sought to examine the cumulative burden and linear rates of change of major metabolic risk factors (MRFs). During 1999–2018, 7,163 candidates (3,069 men) aged 20 to 70 years at baseline with at least three examinations were involved. Study sample involved 743 (316 men) new diabetes participants. In both men and women, relative to those for whom diabetes did not develop, individuals with diabetes had a higher burden of all MRFs and a higher rate of change in BMI, fasting plasma glucose, systolic blood pressure, and diastolic blood pressure. However, the disparities in burden and rate of change between those who did and did not develop diabetes were higher in women than in men. Women's increased sensitivity to and burden of MRFs prior to the onset of diabetes may have consequences for the adoption of gender-specific strategies to avoid or postpone complications of diabetes.