OBJECTIVE: Diabetes mellitus affects over 600,000 people in the Czech republic. The treatment algorithms for diabetic patients currently used in the Czech Republic are in agreement with the international recommendations. We compared data on consumption of antidiabetics (insulin and oral antidiabetics) in the Czech republic with that in other countries. METHODS: Data on insulin and oral antidiabetic drug consumption were expressed in terms of defined daily doses per 1000 inhabitants per day (i.e. DDD/1000 inh/d). RESULTS: Insulin consumption is slowly increasing. Consumption of sulphonylureas is slowly decreasing while that of biguanides is increasing. The proportion of metformin use is more than 50% above that of biguanides. CONCLUSION: It follows from the present comparisons, that the trend in use of insulin in the Czech republic should be interpreted positively. Similarly, the decrease of sulfonylurea use and the increase of that of metformin are good news. On the contrary, a very slow introduction of new classes of antidiabetics to the clinical practice is not good news. New drugs may offer better treatment options, however, their actual value should be properly assessed in clinical practice.