OBJECTIVE: Objectives were to examine prescribing patterns of antidiabetic medications in France over time and to determine how patient characteristics impact the likelihood of receiving various medications. METHODS: Data were obtained from the IMS Disease Analyzer - Mediplus France Database. Patients were eligible if they were identified as having Type 2 diabetes during the calendar year 2001, 2002 or 2003. Univariate analyses examined changes in patient characteristics and trends in prescribing over time. In addition, multivariate logistic regressions were used to analyze how prescribing patterns have changed over time. RESULTS: A total of 14,281 unique diabetic patients were examined over the time period from 2001 to 2003. A unique drug therapy episode was defined as any use of medication or medication combination for at least 45 days. Among users of antidiabetic agents, individuals had an average of 1.28 drug therapy episodes per calendar year. Univariate analyses revealed that between 2001 and 2003, monotherapy use of sulfonylurea decreased (p<0.0001), while monotherapy use of metformin (p<0.0001) and insulin (p=0.0437) increased. Multivariate logistic regressions that compared prescription therapy episodes in 2003 to those in 2001 revealed that the influence of year on likelihood of using metformin or insulin (either alone or in combination with other medications) was positive and significant (p<0.05). In contrast, the influence of year on the likelihood of using sulfonylurea monotherapy was negative and significant (p<0.05). CONCLUSIONS: Antidiabetic medication prescribing patterns have changed in France in the early 21st century. In general, the trend has been away from sulfonylurea monotherapy and towards metformin and insulin monotherapy or combination therapy.