AIMS: To examine trends in the prevalence of self-reported diabetes between 2002 and 2006 among urban adults in Greece. METHODS: Data were derived from two consecutive population-based surveys conducted in Salamis, during two election days (13 October 2002 and 15 October 2006). In both surveys was used the same selection procedure and data were collected using the same questionnaire, completed by almost the same team of interviewers. There were randomly selected 2805 adults (> or =20 years) in 2002 and 3478 in 2006, with similar age and sex distribution to the target population. RESULTS: The overall crude prevalence of diabetes increased significantly, from 245 (8.7%) in 2002 to 358 (10.3%) in 2006 (P=0.037). The age-adjusted prevalence of diabetes among adults was 8.2% (men, 8.5%; women, 7.8%) in 2002 and 9.5% (men, 9.7%; women, 9.3%) in 2006. These changes correspond to a total increasing rate of 16% (4% per year). At the same time, the age-adjusted prevalence of obesity increased from 17.9 to 21.1%, giving an increase of 18% (P<0.05); however, the prevalence of overweight did not increase (43.8-42.9%). CONCLUSIONS: Our findings show that the prevalence of diabetes is rising rapidly in the Greek population and appears to be increasing in parallel with prevalence of obesity.