OBJECTIVES: To describe the clinical and health-related quality of life (HRQoL) impact of patient-reported mild hypoglycaemic episodes and quantify the extent of physician-reported agreement with patient-reported mild hypoglycaemic episodes in patients with type 2 diabetes mellitus (T2DM). METHODS:  We have used data from the Adelphi Diabetes VII (2010) Disease Specific Programme (DSP) which collected data from 379 Primary Care physicians (PCPs) across 5 EU countries - France, Germany, Italy, Spain and UK- for patients receiving at least one oral anti-diabetic with or without insulin. This generated 1145 physician-completed patient record forms (PRFs) that could be matched directly to patient-completed questionnaires (PSCs). Patients were asked: “How often do you have mild low blood sugar experiences (those you have treated by eating some fruit, fruit juice or a sweet)”, while physicians were asked to capture “How often does the patient experience mild (self treated) hypoglycaemic episodes”? RESULTS: 88 patients out of 1093 (8.05%) reported hypoglycaemic episodes, whereas physicians reported that only 39 patients (3.57%) suffered hypoglycaemic episodes. Physician and patient did not agree in 55 cases. The Fisher’s test suggests that the physician-reported prevalence of hypoglycaemic episodes was not influenced by whether or not the patient completed a PSC (p=0.374). Multivariate regression analysis including age, gender, BMI, and duration of T2DM as covariates shows that the utility decrement (HRQoL) is -0.0687 (p<0.01) between the patients who had experienced hypoglycaemic episodes and those who had not. Patients who reported hypoglycaemic episodes also had a significantly higher HbA1c +0.374 (p<0.01) than those who did not report hypoglycaemia. CONCLUSIONS: PCPs in Europe may underestimate the true incidence rate of mild hypoglycaemia as their treated patients report over twice as many as they do. The occurrence of patient-reported hypoglycaemic episodes is associated with lower HRQoL and significantly higher HbA1c and hence has substantial clinical impact.