OBJECTIVE: Type 2 diabetes is recognized as a growing problem across the world, with the number of individuals diagnosed with this disorder expected to approximately double in the next 25 years. The objective of this study is to examine the prevalence of type 2 diabetes as well as trends in antidiabetic medication use in Germany. METHODS: Data for this study were obtained from the German Disease Analyzer - Mediplus database. All patients who were identified with type 2 diabetes between 01/01/2001 and 12/31/2003 and who were at least 20 years of age when first identified as having type 2 diabetes were included in the prevalence estimate (N=45988). While the 2003 prevalence estimate was based on data from a three year window, patient characteristics and medication use was examined for each of the three calendar years. These cohorts consisted of patients identified with type 2 diabetes who were at least age 20 during the year (N=20766 for 2001; N=22778 for 2002; and N=23326 for 2003). RESULTS: The prevalence of type 2 diabetes was estimated to be 3.93% in 2003. From 2001 to 2003, there was a decrease in the percentage of patients with type 2 diabetes who were not receiving antidiabetic medication (from 34.28% to 28.27%; p<0.0001) as well as a significant decrease in the use of sulfonylureas (from 20.02% to 16.02%; p<0.0001). In contrast, there were significant increases in monotherapy insulin use (from 7.95% to 9.90%; p<0.0001), monotherapy metformin use (from 14.04% to 18.71%; p<0.0001), and oral combination antidiabetic medication use (from 14.34% to 16.99%; p<0.0001) over the same time period. CONCLUSIONS: The prevalence estimate confirms that type 2 diabetes is a significant health concern in Germany. Furthermore, recent trends demonstrate that physicians are increasingly likely to prescribe antidiabetic therapies for the treatment of this disease.