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Objective: Comparison of diabetes regulation by strict or less strict observance of the relevant standard protocol of the Netherlands College of General Practitioners (NHG standard)., Setting: Two general practices in the region 'Nieuwe Waterweg Noord', near Rotterdam, the Netherlands., Design: Cross-sectional comparative descriptive study., Method: Type II diabetic patients from two general practices were investigated for diabetic symptoms, type of medication, metabolic abnormalities and (risk factors for) complications in relation to their HbA1c as a measure of mean blood glucose regulation. One GP strictly observed the NHG standard as a protocol, the other GP used it as a guideline., Results: Metabolic control was significantly better in the 'strictly observing' general practice than in the 'guideline' practice: HbA1c 7.3% (SD: 1.7) versus 8.1% (1.5) (p < 0.01). Systolic blood pressure was also significantly lower in the 'strict' practice: 141 mmHg (23) versus 155 mmHg (21) (p < 0.01), but mean age was lower and mean duration of diabetes was significantly shorter. The prevalence of macrovascular complications, diabetic retinopathy and nephropathy did not differ significantly in these practices; symptoms of polyneuropathy, however, were found more often in the patients of the 'strict' practice (41% versus 20%; p < 0.05)., Conclusion: Good metabolic control in patients with type II diabetes mellitus is made possible by strict application of the NHG standard for general practitioners.