OBJECTIVE: To estimate the cost of intensive treatment of DM T2patients (insulin therapy and combined treatment with insulin and oral hypoglycemic agents (OHAs)). MATHODS: The study was conducted for 24 weeks and included 4 visits. In total, 153 patients in DM T2 were examined (65% women and 35% men). The average age was 56.7 years, the duration of the disease was 9.5 years. The cost of treatment included: the cost of patient observation, daily test monitoring, diagnostic manipulations and consultations and cost of the medicines used. Analysis of expenditures was conducted using the incremental cost estimation method that takes into account only the changing quantities. RESULTS: All the patients were divided into two groups in dependence on the result obtained: group 1 (85 pts.), with a level of HbA1c < or = 7.0%, and group 2 (68 pts.), with a level of HbA1c > 7% (p = 0.2784). In group 1, 60 patients received insulin monotherapy and 25 - a combination of insulins and OHAs. In group 2, these subgroups counted 34 and 34 patients, respectively. The intensive treatment was associated with increases in the patient management costs by USD 0.89/patient in group 1 and USD 0.78/patient group 2. The cost of treatment increased because of an increase in the consumption of insulin and expenditures on intensive observation. CONCLUSION: The cost of achieving the clinical efficacy criteria in the group where optimal glycemic control was achieved turned out to be comparable with the cost of managing patients in the group where this control was not achieved. However, in group 1, a decrease in the cost of treatment of concurrent diseases was noted. Thus, proof was obtained: glycemic control is the major determinant of the development of cardiovascular complications of advanced DM.