Objectives: Our current study objective was to assess the nature of antidiabetes prescriptions across the Apollo Sugar Ecosystem, India, a healthcare organization with more than 30 centers (standalone, secondary and tertiary institutions) that provide care to patients with diabetes Methods: An eligible 20608 prescriptions with a diagnosis of type 2 diabetes mellitus (T2DM) from 2017 to 2019 were included in this analyzis to determine the choice of therapy, frequency of usage of a different class of antidiabetes medications, types of insulin, combination and number of oral hypoglycemic agents (OHAs) with insulin. Descriptive statistics were applied to do the analyzis and report the results. Results: The mean age of the patients was 53.2 years, 63% males and 37% females. The majority of the patients were on OHAs (68.2%) with 22.8% of patients on OHAs+insulin and 9.0% on insulin alone. Biguanides (55.7%) were most commonly prescribed in combination with other OHAs followed by DPP4 inhibitors (DPP4i) (35%) and 63% of patients requiring insulin were using at least one oral drug. The most common drugs used along with insulin include biguanides (50.5%) and DPP4i (46.7%). Among Insulins short-acting insulin (45.6%) was most commonly prescribed followed by insulin glargine (22.5%) and premixed insulin and analogues (13.5%) Conclusions: Our large cross-sectional data analysis reveal a significant number of patients on monotherapies other than metformin. The data provided here give a snap shot of the changing trends in the adoption of therapeutic practices with the availability of newer medications, physician education and patient ability to afford care. Keywords: Anti-diabetes drugs; anti-hyperglycemic agents; Diabetes, India; Insulin, Prescription; oral; Type 2 diabetes mellitus