The Otsuka-Long-Evans-Tokushima fatty (OLETF) rat is a genetic model of spontaneous development of non-insulin-dependent diabetes mellitus (NIDDM) established as an inbred strain after 20 generations of selective breeding. Although they are thought to be genetically homogeneous, they show a dimorphism regarding the diabetic phenotype at an advanced age, with one remaining obese and modestly diabetic while the other becomes lean and overtly diabetic. To clarify the causes for this divergence, we examined the physical, biochemical, and histopathological features in rats at 50 weeks of age, including an analysis of islet angioarchitecture. Sixty-one of 85 male OLETF rats lost weight, while the remainder remained obese. Mean nonfasting plasma glucose in the lean group was 21.8 ± 4.6 mmol/L, significantly higher versus the obese group (10.5 ± 1.4 mmol/L) and the age-matched control Long-Evans-Tokushima-Otsuka (LETO) group (7.1 ± 0.6 mmol/L). Morphological studies of the pancreas from the lean group showed enlarged multilobulated fibrotic islets with a paucity of B cells, whereas islets from the obese group appeared slightly enlarged and showed a relative abundance of B cells. The fine capillaries that form a network in the islets were extremely sparse in the lean group, resulting in a defective glomerular-like configuration, whereas those from the obese group were dense, forming a nearly typical glomerular-like configuration. Increased plasma insulin responses to oral and intravenous (IV) glucose and IV glucagon loads were nearly absent in the lean group, while they were evident in the obese group, although to a lesser extent compared with the LETO group. Mean insulin secretory output from the perfused pancreas in response to 11.1 mmol/L glucose in the lean group (3.5 ± 2.2 pmol/20 min) was significantly lower versus the obese group (8.8 ± 6.5 pmol/20 min) and LETO group (22.0 ± 10.8 pmol/20 min). Similarly, pancreatic insulin content was significantly lower in the lean group (9.3 ± 6.1 μg) versus the others (26.1 ± 17.3 μg for obese and 41.1 ± 24.8 μg for LETO). In vivo insulin-stimulated glucose uptake measured by a euglycemic clamp technique was significantly higher in the lean group compared with the obese group. These results demonstrate that the dimorphism regarding the diabetic phenotype in male OLETF rats at 50 weeks of age was due to differences in the number of islet B cells, which could be the result of a variation in the capacity for B-cell proliferation among male OLETF rats.