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AIMS: Several psychosocial factors have been shown to increase the risk of Type2 diabetes mellitus. This study investigated the association between structural social support and incidence of Type2 diabetes mellitus in men and women. METHODS: Data were derived from three population-based MONICA/KORA surveys conducted in 1984-1995 in the Augsburg region (southern Germany) and followed up by 2009. The study population comprised 8952 participants (4669 men/4283 women) aged 30-74years without diabetes at baseline. Structural social support was assessed using the Social Network Index. Sex-specific hazard ratios were estimated from Cox proportional hazard models. RESULTS: Within follow-up, 904 incident Type2 diabetes mellitus cases (558 men, 346 women) were observed. Crude incidence rates for Type2 diabetes mellitus per 10000person-years were substantially higher in poor compared with good structural social support (men: 94 vs. 69, women: 58 vs. 43). After adjustment for age, survey, parental history of diabetes, smoking status, alcohol intake, physical activity, hypertension, dyslipidaemia, BMI, education, sleep complaints and depressed mood, risk of Type2 diabetes mellitus for participants with poor compared with good structural social support was 1.31 [95% confidence interval (CI)=1.11-1.55] in men and 1.10 (95% CI=0.88-1.37) in women. Stratified analyses revealed a hazard ratio of 1.50 (95% CI=1.23-1.83) in men with a low level of education and 0.87 (95% CI=0.62-1.22) in men with a high level of education (P for interaction: 0.0082). CONCLUSIONS: Poor structural social support is associated with Type2 diabetes mellitus in men. This association is independent of risk factors at baseline and is particularly pronounced in men with a low level of education.