AIMS/HYPOTHESIS: We examined whether the 2-h plasma glucose (2 hPG) concentration after a 75 g OGTT is predictive of death in men with a diabetic, an impaired or a normal fasting plasma glucose concentration (DM-FPG: > or =7.0 mmol/l; IFG: 6.1-6.9 mmol/l; normal-FPG: <6.1 mmol/l). METHODS: The 17-year mortality of 7018 men, aged 44 to 55 years, from the Paris Prospective Study, who were not known to be diabetic at baseline was studied. RESULTS: The 2 hPG was not associated with early mortality in men with a DM-FPG in contrast to men with an IFG or a normal-FPG; for an increase from 10 to 11 mmol/l in the 2 hPG, the age-adjusted hazards ratios were 1.01 (95% CI 0.95-1.08), 1.15 (1.03-1.28) and 1.24 (1.18-1.31) respectively. Coronary heart disease mortality and within this category sudden death but not ischaemic heart disease death, were related with 2 hPG but only in the men with normal FPG. However, the prediction by 2 hPG did not differ between the men with DM-FPG, an IFG or a normal-FPG: the overall age-adjusted hazards ratios for these three causes of death were 1.09 (1.00-1.18), 1.13 (1.02-1.26) and 1.13 (0.99-1.29), respectively. CONCLUSION/INTERPRETATION: 2 hPG is unequivocally prognostic for all-cause mortality only in men with normal FPG. Screening men with an IFG by using a 75 g OGTT is of limited benefit.