OBJECTIVES: Severe hypoglycaemias occurring in diabetes care are associated with a major economic burden on healthcare systems, with a major part of the direct costs resulting from the small proportion of patients who are admitted to hospital. We assessed the inpatients costs of severe hypoglycaemic events in Type 1 and 2 diabetes (SHE) patients in France. METHODS: The study was done using the 2012 French National Database on hospital care (PMSI). This comprehensive database covers all hospital stays in the French population (over 20 million hospital stays per year). SHE were identified using ICD10 codes of hypoglycaemias (E160, E161, E162, T383) in combination with diabetes codes (E11, E10, E13, E14, N083) and excluding gestational diabetes. Directs costs to the healthcare system were estimated using the French National Costs study (2011 values). RESULTS: Overall, in 2012, 17,835 stays for diabetes related hypoglycaemias were identified in the database corresponding to 16,406 patients. 8.7% of patients were hospitalized twice in the year for SHE, 51% were male and aged 66.7 years on average (SD 19.7). 90% of stays occurred in public hospitals and mean length of stay was 8.1 days (median 7.0). The mean direct cost of one SHE hospital stay was €4,360. Extrapolated to the whole country the direct cost of hospitalized SHE was €77.7 million which roughly correspond to 1.2% of the overall diabetes costs for the healthcare system. Such value would be considered a conservative estimate due to potential underreporting of cases in the database. CONCLUSIONS: Our study confirmed that hypoglycaemic events lead to substantial costs for the community even it was limited to direct costs in inpatient setting. As the short-term and long term consequences of hypoglycaemia begin to be better understood, more studies have to be done to estimate the full economic burden of this disease.