OBJECTIVES To assess adherence and main causes of discontinuation in diabetic patients who started treatment with glimepiride in real-life settings in Colombia METHODS A cohort of type 2 diabetic patients from 66 centers, who started treatment with glimepiride 4 mg were followed for 1 year. Physical examinations and lab tests were performed according to clinical practice every 3-4 months. Quality of life was assessed (SF-8) at baseline and the end of follow-up. RESULTS 444 patients were included; 43.1% female; mean age: 59.9 ± 12.5 for females and 58.0 ± 13.4 years for men. Most patients had higher education level(73%), 28.5% were retired, and 60% were paying health care out-of-pocket. The most common comorbidity was hypertension (64.1%). Baseline BMI and abdominal circumference: 27.6 kg/m2 and 97.9 cm for males and 27.4 kg/m2 and 93.2 for females. Mean HbA1c levels and fasting blood glucose: 8.3% and 199.88mg/dl. Just 4% had additional antidiabetic medications. After one year of follow-up, information on 82% (n=367) of the patients was available. 75% (n=332)continued the treatment with glimepiride. The main reason to discontinue the treatment was forgetfulness. All patients who continued the treatment improved their glicemic control with significant changes (p<0.05) in mean HbA1c (6.57%) and fasting blood glucose (109mg/dl). Characteristics associated with continuation of treatment, were higher education, higher socioeconomic status, better insurance coverage, and healthy habits. Patients also reported improvement in their quality of life at the end of the follow-up. Only 1 patient reported an adverse event not related with the treatment(hip fracture). No serious adverse events or hypoglycemic events requiring medical attention were reported. CONCLUSIONS In the first year of treatment with glimepiride most patients continue the therapy, and the main reason for discontinuation was forgetfulness. Patients who are adherent to their antidiabetic therapy, with glimepiride in Colombia, improve glicemic control and improve their self-rated health status