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Background: The aim of this study is to assess for the change in progression of inflammatory, adiposity, and atherosclerotic markers in first degree relatives of type 2 diabetes mellitus patients. Methods: Normal glucose tolerant (NGT) individuals (20–40 years) who had positive family history of T2DM (FHP) were enrolled in this prospective study based on ADA 2015 criteria. Age, sex, and BMI matched controls without any history of diabetes in their parents referred as family history negative (FHN) were taken for comparison. At baseline, detailed clinical assessment and requisite blood/imaging investigations were done. All the available subjects from the original cohort (FHN-32 and FHP-46) were studied after 2 years with recording of the clinical, biochemical and imaging parameters. Results: A total of 64 cases (FHP) and 42 controls (FHN) were enrolled at baseline. FHP group had significantly higher hsCRP (p = 0.039) and cIMT (p = 0.003) than that of FHN group. No significant difference in the rate of conversion of NGT to prediabetes (using multiple criteria) was found after 2 years between the two groups. cIMT was increased significantly from baseline in FHP group than FHN group at the end of the study(0.02 ± 0.03 vs. 0.01 ± 0.02 mm, p = 0.002). But there was no significant difference for changes in glycemic status, lipid parameters, HOMA IR, hsCRP, and adiposity markers between the two groups at the end of the study. Conclusion: Despite no significant differences in change in glycemic parameters or rates of conversion from NGT to pre diabetes, cIMT increased significantly in the normoglycemic offspring of T2DM subjects than those without history of T2DM in their parents. [ABSTRACT FROM AUTHOR]