Objective: This study investigated trends in prescription of hypoglycemic agents in patients with type 2 diabetes, focusing on changing prescription pattern and cost of drugs from 2002 to 2013. Methods: Retrospective data was extracted from a large national population-based study in patients with type 2 diabetes aged 30 years or older using the Korean National Health Insurance System database. We analyzed the prescribing information on patients, and fixed-dose combination tablets were counted as each of their constituent classes. Results: The number of adult type 2 diabetic patients with treated hypoglycemic agents increased from 0.8 million in 2002 to 2.7 million in 2013. Among 0.8 million antidiabetic prescriptions in 2002, sulfonylurea (SU) was the most commonly used agents (87.2%), and metformin held the second rank (52.9%). However, in 2013, metformin use increased to 80.4% of total prescriptions. Among prescriptions for monotherapy, only 11.7% was metformin in 2002, but it increased up to 56.4% in 2013. In contrast, SU use steadily declined from 76.7% in 2002 to 28.3% in 2013 as monotherapy. Among hypoglycemic agents, the dipeptidyl peptidase-4 (DPP-4) inhibitors increased dramatically since 2008, and comprised most dramatically increased share with 1 million prescriptions (38.4%) in 2013. Dual and triple combination therapy was steadily increased from 39.8% and 19.1% in 2002 to 40.6% and 31.4% in 2013, respectively.In addition, 10.4% of total prescriptions for dual therapy accounted for insulin combination. Total drug cost has been steadily increased from 117 billion won in 2002 to 690 billion won in 2013, respectively. Conclusion: According to increase in patients with type 2 diabetes, use of hypoglycemic agents and their costs have been increased steadily. Metformin is the most commonly used recently. The use of DPP4 inhibitors increased significantly over the past decade, while the use of SU has decreased. But SUs remained the most commonly prescribed class of second-line agents.