OBJECTIVES: To compare the burden of disease attributable to diabetes expressed in Disability Adjusted Life Years (DALYs) for five European countries in 2010. METHODS: DALYs lost to diabetes as the sum of years of life lost and years lived with disability were estimated by gender and age using country-specific epidemiological data and global disability weights. Data from various secondary sources were combined to estimate health loss due to diabetes for France, Germany, Italy, Spain and the UK. National statistical databases were used and in case necessary, community studies were used to derive the prevalence of diabetes by gender and age group which were weighted proportionately for a national population burden of disease estimate. All identified data were adapted to the Global Burden of Disease methodology (2010) to calculate the burden attributable to diabetes. No age weighting and discounting was applied. Sensitivity to different sources of variation was examined. RESULTS: Germany and Italy lost the largest number of DALYs due to diabetes with 5.9 and 5.8 per 1,000 inhabitants respectively, followed by Spain (4.4), France (3.7) and the UK (2.9). The highest burden was caused by mortality due to diabetes, with the exception of the UK, for which the burden due to disability of diabetes was higher. This may be explained by the way of reporting death in the UK. Mean DALYs lost were higher for women in Germany, Italy and Spain and showed to increase with age for all countries. Sensitivity analysis in variation in disability weights and uncertainty in epidemiological data showed to have effects on DALYs lost.  CONCLUSIONS: In spite of data limitations, the estimates reported here show that DALY loss due to diabetes imposes a substantial burden on countries. Cross-national variation in disease epidemiology was the largest source of variation in the burden of diabetes between countries.