Background: Papua New Guinea, like other low and middle income countries in economic transition, is experiencing enormous burden of lifestyle-related non-communicable diseases due in part to rapid urbanisation. Kimbe, the provincial capital of West New Britain is the fastest growing city in the South Pacific subcontinent yet its impact on diabetes mellitus (DM) is not known. Objective: To determine pattern of DM diagnosed on admission on subjects who reside in Kimbe urban compared to those who live in rural areas. Design: This was a retrospective review of medical wards admission data contained in Kimbe General Hospital register from January 2009 to December 2012. The study was conducted on subjects who were prior to admission not known to have diabetes. Result: Over a period of 4 years, 125 patients (58.4% of whom were non-indigenes of the province) were diagnosed with type 2 diabetes with female: male ratio of 1: 1.1. Majority of the patients was of young population aged <50 years representing 72 % of the cohort. Almost 3/4th of the newly diagnosed diabetic population were based in Kimbe urban with only 32 subject (25.6%) identified as rural residents; Odds Ratio (OR) 25.5, 95% CI 17.0-38.2, p<0.0001. The number of patients diagnosed with DM over the study period progressively increased: 16, 22, 38 and 49 in 2009, 2010, 2011 and 2012 respectively; p <0.05. Conclusion: This study suggests that subjects living in area of rapid urbanization are at higher risk of diabetes compared to residents of rural areas. There is a need to strengthen DM education, screening and primary prevention of the disease in the identified high risk population.