Low serum AMY values were previously reported to be associated with incident T2DM. We further investigated that association in detail by showing the combined effects of chronological changes in AMY and baseline AMY as well as results of stratified analyses of baseline age and HbA1c. Analyzed were 5306 individuals who had health examinations yearly for 7 y. We monitored changes in AMY values between baseline1 (first visit) and baseline2 (2 y later). Multivariate Cox analysis was conducted to evaluate the impacts of baseline2 AMY and change in AMY on incident T2DM in consideration of age and HbA1c. During the 5-y follow-up, T2DM occurred in 716 patients. Both low baseline2 AMY and decrease in AMY were independently associated with the development of T2DM. Compared with those whose baseline2 AMY ≥57 (Quintiles (Q) 2-5) and changes in AMY ≥90.4 (Q 2-5), those whose baseline2 AMY ≤56 (Q1) and changes in AMY ≤90.3 (Q1) had a significantly increased risk for T2DM (HR 1.60 [1.22-2.09]). Stratified analyses by age and baseline HbA1c levels showed that the increased risk for T2DM due to low baseline2 AMY or its change occurred only among those <50 y old or with HbA1c levels <5.6%. These findings imply the clinical relevance of using AMY values and their chronological changes over time for evaluation of T2DM risk among individuals who are relatively young or have low HbA1c. Disclosure I. Ikeda: None. K. Fujihara: None. I. Risa: None. M.H. Yamada: None. R. Nedachi: None. M. Hatta: None. S. Kodama: None. Y. Mori: None. Y. Matsubayashi: None. Y. Arase: None. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co. R. Yamamoto-Honda: None.