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Type 2 Diabetes Mellitus (DM) is a condition primarily defined by the level of hyperglycemia giving rise to the risk of microvascular and macrovascular complications. It is associated with reduced life expectancy, significant morbidity and diminished quality of life. The aim of the study was to assess the prevalence and prescribing pattern in Type 2 DM and its complications in a tertiary care hospital. It was a prospective observational study carried out among 200 patients for 6 months in a tertiary care hospital. Patient's details were collected from case sheets and entered into data collection form. Hyperglycemia was managed with insulin (75.5%) due to its proven effectiveness; oral hypoglycemic agents (OHA) (24.5%) were prescribed to a limited extent. For diabetic nephropathy, beta-blockers (43%) were the highest prescribed. Pregabalin was mostly prescribed (35.8%) in diabetic neuropathy. The diabetic foot was commonly managed with clindamycin (61.5%), but treatment differed based on cultural sensitivity. Ischemic heart disease (IHD) was found to be the most prevalent complication in our study setting (41.5%). Macrovascular complications were managed with antihypertensives, diuretics, antianginals, anticoagulants, antiplatelets and antihyperlipidemics. The association of risk factors with diabetic retinopathy and IHD with duration of DM and HbA1c was statistically significant (p=0.007, p=0.05; p=0.007,p=0.004 respectively) Prescribing trend of drugs was based on the severity of complication, associated comorbid conditions and presently existing evidence to promote the rational use of drugs.