OBJECTIVES: Determine the direct cost of treatment for patients with Type II Diabetes (T2D) in Greece. METHODS: In order to define the patient management model, a 2-step methodology was implemented. First, a questionnaire-based survey was conducted in a random sample of 51 physicians specializing in the treatment of T2D, geographically distributed according to the total population of T2D patients in Greece. Participating physicians were asked to review their patient records before completing the questions regarding patient resource utilization and other specific treatment parameters. As a second step, the survey findings were reviewed by an expert consensus panel for validation and final definition of the data for the analysis. Patients were categorized as (a) regulated (i.e. maintaining glucose levels within therapeutic range for a 1-year period) and (b) non-regulated. Cost analysis was based on estimation of 1-year direct cost of treatment (physician consultations, laboratory/diagnostic tests and pharmacotherapy - insulin and oral hypoglycemic agents), based on 2007 private sector fees and prices, in Euros. Hospitalization costs were not included. RESULTS: Average direct cost for regulated patients (46% of total T2D patient population) was estimated at €983/year, while for the non-regulated (54%) it was significantly higher, at €1570. For regulated patients, laboratory/diagnostic tests accounted for 43.6%, physician consultations for 21.8% and pharmacotherapy for 34.6% of the total average cost, whereas for the non-regulated the respective values were 45.9%, 26% and 28.1%. Weighted average patient cost was calculated at €1300/year, resulting in a total cost of approximately 1 billion Euros/year for the estimated 780,000 T2D patients in Greece. CONCLUSIONS: Although not including the cost of hospitalizations and complications, which account for approximately 2/3 of the total patient cost, as reported in the literature, this study demonstrated the importance of blood glucose control/regulation, not only from the clinical but from the economic perspective as well.