Aim/hypothesis Individuals at risk of developing type 2 diabetes show a progressive decline in insulin secretion and increased insulin resistance over time. However, inability of the beta cells to compensate for the increased insulin resistance represents a key defect leading to overt type 2 diabetes. The aims of the present study were to replicate the association between genetic variants of the PCSK2 gene and insulin secretion, and to explore the effect on risk of type 2 diabetes. Methods Replication of PCSK2 variants against insulin secretion included 7,682 non-diabetic Scandinavian individuals. Insulin secretion was measured as the corrected insulin response or disposition index, i.e. insulin secretion adjusted for the degree of insulin resistance. Risk of type 2 diabetes was studied in 28,287 Scandinavian individuals. Results The C-allele of PCSK2 rs2208203 was associated with reduced insulin secretion measured as the corrected insulin response (n08,151; β0−0.112, p01.3×10 −6 ) as well as disposition index (n08,078, β0−0.128, p01.6×10 −7 ).The variant was also associated with lower fasting glucagon levels (β0−0.084, p00.005) in non-diabetic individuals with a fasting plasma glucose of over 5.5 mmol/l. In human pancreatic islets, PCSK2 expression correlated negatively with HbA 1c (n0133, r0−0.196, p00.038), and showed a tendency to be lower in hyperglycaemic (HbA 1c ≥6.0% or type 2 diabetes; n 047, p 00.13) than normoglycaemicElectronic supplementary material The online version of this article