OBJECTIVES: : During the progressive course of type 2 diabetes mellitus (T2DM) a sizeable proportion of patients require insulin therapy to maintain long-term glycemic control. The objective of this study was to realize a snapshot of characteristics and glycemic control of patients with T2DM treated by insulin in five European countries. METHODS: T2DM patients, over 40 years old, treated by insulin (basal only therapy [BOT], premix, prandial or a basal-prandial free combination) ± non-insulin antidiabetic drugs for at least 18 months, were identified in primary care electronic medical record databases of France, Italy, UK; Germany and Spain (IMS Health Longitudinal Patient Databases) during years 2013-2014. Patients’ characteristics, medical history, treatment regimen, HbA1c values were retrieved and analyzed RESULTS: Median age was 71.4 years in Italy (n=7339), 70 in Germany (n=3079), 67 in UK (n=16,941), 68.2 in France (n=3046) and 70.3 in Spain (n=1710). About half of patients had a BMI ≥ 30 and hypertension was present in 69% (UK) to 88% (Germany). A majority was treated with BOT in France (51%) and Spain (60%), basal-prandial in Italy (48%) and in Germany (33%), and premix insulin in UK (41%). BOT was the second most commonly prescribed regimen in Germany and Italy. Metformin was the most frequently prescribed concomitant oral antidiabetic drug. Mean HbA1c was 7.8% in Italy, 7.7% in Germany, 8.4% in UK, 7.9% in France and 8% in Spain. Overall, more than three quarter of patients (between 74% in Italy and 83% in UK) had a HbA1c ≥7%, whilst 33% (Germany) to 55.5% (UK) of them had a HbA1c ≥8%.   CONCLUSIONS: While regimens and patients characteristics may vary among countries, these results show that, despite having been treated with insulin for at least 18 months, a sizeable proportion of patients exhibit a suboptimal glycemic control.