OBJECTIVES: To assess diabetes disease burden and associated treatment patterns among six European nations. METHODS: A large multi-country online cross-sectional survey of approximately 175,000 adults was conducted in 2007 in France, Germany, Italy, Spain, UK and the Netherlands by TNS Healthcare. The survey enabled TNS to build an epidemiological database based on its proprietary European Healthcare Panel (EHP) of consumers in these 6 countries. The data is representative of population gender and age (18-24,25-34,35-44,45-54,55-64,65-69yrs) strata in respective countries, ensured by sampling and intensive panel management. The survey collected information on select health conditions (incl. diabetes; in the past 12-months) and healthcare-utilization. RESULTS: Diabetes disease prevalence varied widely between the 6 nations, as follows (All pts, Males/Females, proportion type 1/type 2/Gestational/Unknown): Italy: 4%, 5%/3%, 28%/61%/3%/8%; France: 5%, 5%/4%, 21%/63%/4%/12%; Spain: 5%, 6%/4%, 18%/66%/3%/13%; Netherlands: 5%, 6%/5%, 13%/84%/1%/1%; Germany: 6%, 6%/5%, 14%/81%/1%/4%; UK: 7%, 4%/6%, 16%/79%/2%/4%. Within each country, burden of type 2 diabetes tended to increase with age among diabetic individuals (all-age,18-24,25-34,35-44,45-54,55-64,65-69yrs: % pts): Italy: 61%,17%,16%,31%,66%,79%,61%; France: 63%,7%,19%,46%,61%,73%,76%; Spain: 66%,18%,16%,44%,75%,68%,93%; UK: 79%,10%,34%,64%,84%,89%,93%; Germany: 81%,22%,27%,60%,82%,91%,85%; Netherlands: 84%,50%,50%,71%,86%,89%,92%. Type of treatment observed among type 1/type 2 diabetics varied across the countries (not mutually exclusive: % using Dietary restrictions/exercise, Oral-therapy/oral-antidiabetics, Insulin therapy): Netherlands: type 1 – 16%,4%,92%, type 2 – 39%,63%,22%; UK: type 1 – 19%,13%,81%, type 2 – 39%,62%,16%; Spain: type 1 – 33%,13%,73%, type 2 – 57%,61%,17%; Germany: type 1 – 19%,17%,79%, type 2 – 61%,54%,25%; France: type 1 – 52%,44%,35%, type 2 – 66%,78%,16%; Italy: type 1 – 58%,27%,44%, type 2 – 79%,77%,14%. Among those using medications to manage diabetes, prescription medicines predominated (range: 74% (Spain) to 86% (Netherlands)); use of OTC-products/complementary-therapy was rare (<1%-3%), and so as herbal-therapy (<1%-4%, except in Spain (12%)). CONCLUSIONS: Diabetes disease burden appear to be substantial in European nations studied, with type 2 diabetes burden increasing with age. The reported treatment patterns varied dramatically. With the aging European population, appropriate interventions, outcome evaluations and cost-effective diabetes management strategies are warranted to alleviate this burden.