INTRODUCTION: Despite the progress of clinical trials, clinicians and decision-markers often lack knowledge on how to better promote health care delivery to patients with T2DM in clinical practice. Outcome research studies can provide effectiveness and economic analysis in actual practice in order to improve clinical performance. OBJECTIVES: To describe the resources used and the costs associated with outpatient treatment of T2DM in the Brazilian PHS. METHODS: This is a cross-sectional analysis of 383 T2DM outpatients treated in 5 cities by various health plans. Data was collected using info from the previous year by interviewing patients using a validated questionnaire complemented by medical chart review. Direct costs included expenses associated with medications, diagnostic tests, procedures, blood glucose test strips and health professional visits. Non-medical direct costs included expenses with diet products. Indirect costs were not assessed. RESULTS: The group had a mean age of 60.5±9.6 years and a mean duration of diabetes of 12.2 ± 8.75 years. Annual outpatient cost of T2DM care was R$10,645.78 per patient, being R$9,534.58 for direct medical costs and R$1,111.20 for non-medical costs. Costs escalated as duration of diabetes increased (R$8,796.68 per patient <9 years vs R$13,231.74 >19 years of disease; p=0.05). Those patients with associated microvascular and macrovascular complications (n=18%) have higher costs (R$15,755.12 per patient) compared to those with microvascular (R$9,178.38 per patient; n=32.4%), macrovascular (R$8,726.13 per patient; n=8.1%) or no complications (R$8,246.53 per patient; n=41.5%). Annual per patient expenses included medications (R$5,542.94), blood glucose home monitoring (R$1,014.62), private health professional visits (R$4,264.04) and diet products (R$1,111.20). Health plans expenses per year were due to exams/procedures (R$588.02 per patient), medications co-payment (R$1,029.00 per patient) and health professional visits (R$734.12 per patient). CONCLUSIONS: The outpatient care costs assessed reveal that diabetes poses a serious social and economic burden to patients and to Brazilian PHS.