OBJECTIVES: To examine the initiation of oral antihyperglycemic agents (OAHAs) and/or statins in patients with type 2 diabetes mellitus (T2DM) and assess the time elapsed from diagnosis to treatment initiation and intensification when goals were not achieved in real world practice. METHODS: A retrospective study was performed on 662 medical records of patients with T2DM, diagnosed 24 to 48 months prior to signing the informed consent. The study included thirty-one general practitioner/specialist sites across Mexico, Argentina and Brazil. Inclusion criteria: age ≥21 years at diagnosis; complete record of pre-diagnosis medication and pre-existing CV risk factors and 2 years follow-up records. Exclusion criteria: type 1 diabetes; pregnancy; receiving antihyperglycemic agents or statins prior to diagnosis; initially treated with insulin after T2DM diagnosis; or clinical trial participation during the study period. Descriptive statistics were used for demographic/clinical characteristics. Kaplan-Meier test was used to examine time to treatment and cumulative treatment probability and multivariate logistic regression examined factors associated with such treatment. RESULTS: At diagnosis, patients had a mean age of 53 years; 44% had hypertension, 42% were obese and 23% had hypercholesterolemia. During the 2-year follow-up period, 93% were treated with OAHAs but only 29% of those eligible for statin therapy received statins. Time elapsed before first prescription of OAHA was 59±141 (Mean±SD) and 1 (1, 31) (median [IQR]) days and 230±232 days and 132 (30, 406) days for statin. No variables were associated with OAHA initiation but family history of T2DM and hypercholesterolemia at diagnosis were associated with statin initiation. No antihyperglycemic treatment intensification was recorded in 51%/53% of patients with HbA1c/FPG values above treatment targets during the follow-up period.  CONCLUSIONS: The delay in treatment of hypercholesterolemia and intensification of treatment for hyperglycemia in patients with T2DM not attaining treatment targets works against effective prevention of chronic complications.