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There are no national estimates for the prevalence of DM in Bosnia and Herzegovina (BiH), available data is extrapolated from neighboring countries. This study aimed to determine the prevalence of DM, as well as utilization of antidiabetic drugs (ADs) and exposure rates of DM patients to ADs in the eastern region of the Republic of Srpska (RS), BiH. For external reference, data were compared to that from Serbia, Hungary and Norway. Data on the number of all adult patients with DM type 1 and 2 in the three municipalities in the eastern region of RS were obtained from medical records. The use of ADs in the RS, Serbia, Hungary and Norway for the year of 2013 was analysed by ATC/Defined Daily Dose methodology. The exposure of DM patients to ADs was expressed in percentage. The recorded DM prevalence in the three observed municipalities was 6.65%, with high proportion of type 1 compared to type 2 DM (25.32% to 74.68%). The total consumption of ADs recorded in our study was similar to those in Norway, but lower than in Serbia and Hungary. The percentage of theoretical exposure of each patient to ADs was only 78,24%, similar to that in Serbia (80.6%), whereas Norway and especially Hungary had exceptionally good exposure rates (103,8 and 126.5%). High proportion of type 1 DM patients recorded in our study indicates the insufficient detection of DM, especially type 2, whereas the low exposure rate of patients with DM to ADs indicates that even the registered patients with DM are undertreated. There is an urgent need for interventions in prevention and treatment of DM in BiH.