To study the prescribing pattern of anti-diabetic drugs in newly diagnosed type 2 diabetes mellitus (T2DM) patients. METHODS: Retrospective  observational  study,  carried  out  in  a  south  Indian  tertiary  care teaching hospital. Institutional ethics committee approval was obtained prior to the study. As per the study criteria, data of newly diagnosed T2DM patients admitted during the year 2013 and 2014 was collected from medical records department (MRD) registry using ICD code E 11.9. Drug utilization was measured as DDD/1000 diabetic patients/day. RESULTS: During the study period total 662 patients were newly diagnosed with T2DM. The mean age of the study population was 52.5 ± 12.5 years (mean±SD) and 64.5% of patients were male. 164 patients had over weight and 67 patients were obese. Generalized weakness (n=89), fatigue (n=70) and polyuria (n=41) were the most common symptom present at the time of diagnosis.  Among the study population 39.4% patients received single anti-diabetic drug, 29.3% patients received dual anti-diabetic drug and 17.8% patients received multiple anti-diabetic drug treatment. 39.9% patients received only oral anti-diabetic drugs, 18.6% patients received only insulin therapy, while 28.1% patients received combination of oral anti-diabetic drugs and insulin therapy. Consumption of insulin was 4.1 DDD/1000 diabetic patients/day in 2013, which was increased to 6.3 DDD/1000 diabetic patients/day in 2014. Among the oral anti-diabetic drugs biguanides (58.2%) was the most common prescribed, followed by sulfonylureas (29.3%) and alpha-glucosidase inhibitors (5.4%). Combination of biguanides and insulin was prescribed to 11.9% patients. Among the oral anti-diabetic drugs, consumption of metformin was highest both in 2013 and 2014 (2.7 DDD/1000 diabetic patients/day), whereas consumption of sulfonylureas was decreased from 1.8 DDD/1000 diabetic patients/day in 2013 to 1.6 DDD/1000 diabetic patients/day in 2014. CONCLUSIONS: This study reveals that insulin and metformin was the most prescribed anti-diabetic drug in our hospital.