OBJECTIVES: To assess the level of adequate glycemic control in real life practice settings in Hungary in adult patients with type 2 diabetes mellitus (T2DM) who added a sulfonylurea (SU) or glitazone (PPAR) to ongoing metformin(MF) monotherapy. METHODS: Retrospective clinical chart reviews and patient surveys at the point of visit (January 2006-March 2007) were conducted in Hungary. Patients were °Ý30 years of age at time of T2DM diagnosis and added a SU or PPAR to previous MF monotherapy irrespective of whether those drugs were discontinued afterwards. Information on A1C, medication use and co-morbid conditions was extracted from clinical charts, for up to a 7 month baseline period (MF monotherapy) and for a minimum of one year follow-up period (between therapy addition and date of survey). Glycemic goal attainment at A1C < 6.5% was assessed according to the IDF (2005) recommendations using the last available A1c value during follow-up. RESULTS: In total, 401 patients (85% SU + MF and 15% PPAR + MF) of which 52.1% males, were recruited. For the SU+MF and PPAR+MF groups respectively: mean age was 61.0(SD=9.3) and 57.9(SD=11.4) years; duration of diabetes was 7.53(SD=5.1) and 6.6(SD=4.2) years; A1C during MF monotherapy was 8.4(SD=1.6) and 7.6(SD=1.4); A1C since combination therapy was 7.9(SD=1.3) and 7.1(SD=1.3). Patients at goal after addition of SU was 21.7% and 26.7% were at goal after addition of PPAR. In total, 14.2% initiated insulin since the addition of SU to MF, 3.3% initiated insulin since the addition of PPAR to MF. CONCLUSION: Several differences were seen between the groups who added SU or PPAR to MF, including age, duration of diabetes and A1C values. In both groups, approximately three quarters of patients with T2DM failed to attain glycemic control goal since initiating oral combination therapy.