OBJECTIVES: Hypoglycemia represents a barrier to optimum diabetes management. It also places a burden on national healthcare budgets, and affects patient quality of life. The purpose of this study was to evaluate the costs of insulin-related hypoglycemia in Algerian adult patients aged 20-79 years, and treated for Type 1 (T1DM) or Type 2 Diabetes Mellitus (T2DM). METHODS: A prevalence-based cost-of-illness approach was used to estimate the costs of non-severe nocturnal hypoglycemic events (NSNHEs), non-severe hypoglycemic events (NSHEs), and severe hypoglycemic events (SHEs), from societal perspective. The population size and structure, events incidence rates, direct costs (blood glucose self-monitoring, assistance, transport, and healthcare resource utilization), as well as indirect costs (productivity loss) were derived from the BAROMETER RWE nationwide dataset (N = 961 T1DM and 14,609 T2DM patients enrolled), the National Office of Statistics databases, and published literature. RESULTS: In 2019, the numbers of NSNHEs, NSHEs, and SHEs were respectively estimated to 5,058,354 ; 15,729,723 ; and 140,023 events (i.e. incidences of 9.8 ; 30.5 ; and 0.3 events per patient-year). The overall cost of hypoglycemia in Algeria was DZD 42.9bn (USD 334m), of which 26% were in relation with T1DM, and 74% with T2DM. Direct costs of NSNHEs, NSHEs and SHEs were estimated to DZD 536m (USD 4.2m), DZD 2.6bn (USD 20.2m), and DZD 5.6bn (USD 43.7m), respectively. Whereas, indirect costs of hypoglycemia associated to productivity loss were of DZD 8.4bn (USD 65m) for NSNHEs, DZD 23.3bn (USD 181m) for NSHEs, and DZD 2.5bn (USD 19.6m) for SHEs, representing respectively 1,166,746 ; 3,251,786 ; and 351,342 patient-productivity days lost. CONCLUSIONS: This study has shown that hypoglycemia leads to substantial costs for community, and impacts heavily on productivity of insulin-treated adult patients in Algeria. Even it is established that hypoglycemic events are more frequent in T1DM, the associated economic burden of events was found to be three times higher in T2DM.