OBJECTIVES: Health expenditure to treat and prevent T2DM and its complications was estimated at USD 345 million for OECD countries in 2010.  These costs pose a great burden to the national health system’s budget, which is already under pressure. In Greece there are no studies that provide information on the costs of T2DM patients including the cost of complications, hospitalizations and co-morbidities. The current study aimed to estimate the total cost of T2DM patients from a third party payer perspective. METHODS: A retrospective research study was performed in four major hospital diabetes centers and 211 patients with at least 10 years of T2DM since diagnosis.  Patients were categorized in two groups, controlled and uncontrolled. Hospitalization and management of complications was based on DRG cost. Pharmaceutical and diagnosis cost was based on official NHS prices.  Health care cost corresponds to 2012 Euros and the perspective used was of the Social Security Fund. Subgroup analysis was performed in order to evaluate the cost difference between controlled vs. uncontrolled, obese non-obese and various other subgroups. RESULTS: The mean average yearly cost of T2DM was €7.111 whereas only 18.8% was attributed to cost of antidiabetic drugs. Diabetic men cost 2.222€ more per year in comparison to diabetic women, whereas obese diabetics cost 1.460€ more per year in comparison to overweight and normal patients. These may be explained by the higher levels of HbA1c, co-morbidities and the number of antidiabetic treatments.  In addition, diabetic patients with low education level cost 2.341€ cost more on average in comparison to better educated patients. CONCLUSIONS: T2DM is an expensive to treat disease and in the era of limited resources and escalating costs it is critical to implement sound public health policies in order to achieve patient’s good glycemic control and consequently less burden to health care budgets.