OBJECTIVES: To evaluate the association between hypoglycaemic events (HEs) and short-term disability (STD) using a retrospective case-control design among patients with diabetes receiving insulin therapy within a claims database. METHODS: U.S. medical claims data was obtained from Thomson Reuters MarketScan Commercial, Medicaid, and Health and Productivity Management databases from 1 January 2007 to 31 December 2009. Patients were selected if they were enrolled in a health plan, eligible for STD for ≥12 months from the first date of an anti-diabetic drug claim (index start date), and had ≥1 insulin claim. Analysis was performed comparing patients who had at least 1 HE claim entered to those who had none. HEs were defined based on ICD-9CM codes: 250.8, 251.0, 251.1, or 251.2 and probably were serious/significant events entered on behalf of the patient. STD was measured by a binary indicator, number of cases, and total days absent from work. The relationship between HEs and STD was evaluated before and after adjusting for covariates. Regression models were used to adjust for known influential covariates (duration of index period and Charlson Comorbidity Index) and fixed effects (sex, age group, region, health plan type, employment status, diabetes type, prescription regimen, and diabetic complications). RESULTS: There were 15,020 patients who met the inclusion criteria with a mean index period of 2.4 years. 478 (3.2%) had experienced ≥1 HEs and 3893 (25.9%) ≥1 STDs. The odds of having ≥1 STDs for those with ≥1 HEs was 74.7% higher than those with no HE (Adjusted OR: 1.747; 95% CI: 1.429, 2.135). Patients reporting HEs had an average of 3.24 more days of absence from work per year due to STDs than patients without HEs after adjusting for the covariates. CONCLUSIONS: Results indicate a significant association between experiencing HEs and the occurrence of STD among patients receiving insulin therapy.