OBJECTIVES: Aim of this study was to evaluate the quality of medical treatment of diabetes patients and its trends in the Czech Republic and to compare the findings with the international research. Based on IDF prevalence of diabetes was 9,7% in 2007 and is expected to rise to 11,7% in 2025. METHODS: Data were extracted from Czech cross-sectional studies from 2002 and 2007 and from European-based studies. Follow-up of short term parameters of quality of healthcare (HbA1c, BMI, blood pressure, lipids, treatment algorithms) which help to predict long-term incidence of complications. Frequency of microvascular and macrovascular complications was also assessed and the data were compared to statistics of the Czech Institute for Health Information and Statistics. RESULTS: Concerning short-term parameters there is wide variation accross European countries. We have not found significant differences between CR and selected European countries although there is insufficient evidence in revealing end-point values, e.g. HbA1c (7,7 % in CR vs. 7,8 % in Great Britain), BMI (29,9 in CR vs. 28,7 CODE-2 study) and reaching of target HbA1c values (36-42% in CR vs. 36% in CODE-2). 74 % of Czech patients compared with 50 % European patients are treated with metformin. Percentage of patients using antihypertention drugs (83 %) and hypolipidemics (63 %) is similar in CR and the European average. The diabetic patients are reaching the tagret therapeutic values only in minority of cases (31% in systolic blood pressure, 27% in total cholesterol and in 36% of HbA1c). There is high prevalence of diabetic macrovascular and microvascular complications (CHD=49%, stroke=9,3%, nephropathy=28,3%, retinopathy=25%, diabetic foot=4,6%). CONCLUSIONS: This comparative analysis is the first example of systematic evaluation of the quality of health care concerning diabetes patients in CR. The future objective is to set proper quality indicators and follow them on continuous basis.