OBJECTIVES: Maintaining long-term glycaemic control with insulin therapy can reduce the risk of vascular events associated with Type-2 diabetes mellitus (T2DM). The Cardiovascular (CV) Risk Evaluation in people with T2DM on Insulin Therapy (CREDIT) study is an ongoing 4-year, noninterventional trial in 314 centres across North America, Europe and Asia. METHODS: People with T2DM who recently started insulin were included. Here we report variation in baseline characteristics of participants in eastern vs northern vs southern Europe. RESULTS: Marked differences in participant characteristics were found between eastern Europe (n=735), northern (n=460) and southern Europe (n=647), including proportion of males (25 vs. 61 vs. 56%), diabetes duration (8±5 vs. 9±6 vs. 13±9 years), age (58±8 vs. 63±11 vs. 63±11 years) and HbA1c (9.7±1.9 vs. 9.1±2.0 vs. 9.3±1.9%). Combinations of oral glucose-lowering drugs were common before insulin; sulfonylureas were dominant in eastern Europe and metformin elsewhere. Over 80% were taking non-glucose medications before insulin initiation, most commonly ARBs. People in eastern Europe had a greater family history of CV disease, were less physically active, but were not more obese (BMI: 30.7±5.4 vs. 31.5±6.3 vs. 29.6±5.9 kg/m2). Rates of hypertension were lowest in southern Europe. HDL cholesterol in males was lowest in northern Europe and in females was highest in eastern Europe. LDL cholesterol was highest in southern Europe. Total cholesterol levels were lowest, but triglyceride levels were highest in northern Europe. Smoking was less prevalent in eastern Europe. Most people began with a basal insulin regimen (60 vs 63 vs. 62%); more people used meal-time insulin in eastern Europe (19 vs. 11 vs. 17%) and pre-mixes in northern Europe (22 vs. 28 vs. 13%). CONCLUSIONS: Baseline characteristics of people starting insulin reveals some striking differences between European regions; how these translate into CV events as the study progresses will be of interest.