Study on first degree relatives of Bangladeshi prediabetic subjects explore that they are at increased risk for developing different types of glucose intolerance. Age-matched healthy controls were without any family history of DM or prediabetes. HOMA% B was significantly lower among first degree relatives all types of prediabetic and HOMA% S in only relatives of IFG-IGT subjects were significantly lower compared to controls. BMI values higher than 23 had significantly less insulin sensitivity compared to their counterparts with BMI less than 23. All the relatives showed significantly higher postprandial serum glucose and dyslipidemia was evident as compared to control. So beta cell secretory dysfunction seem to have a genetic origin in first degree relatives of prediabetes and the genesis of the various phenotypes of prediabetes results from a complex interaction between this primary defect and other factors like BMI, body fat mass, early lipid abnormality and waist circumference contributing to insulin resistance.