OBJECTIVES: HIPOS-ER is an observational, cross-sectional, multicenter study to characterize the population of Type 2 Diabetics treated with an anti-hyperglycemic agent (AHA) who were admitted to the emergency room (ER) with a hypoglycemic event. This is the first national ER hypoglycemia study and the first study collecting primary resource data in this setting. Here we aim to describe this population and the hospital management.  METHODS: The study enrolled patients from 7 centers in mainland Portugal from Jan 2013 – Jan 2014. Sociodemographic and clinical data were collected within the emergency room and patients who required hospital admission were followed-up. RESULTS: A total of 238 events were recorded. Mean age: 76 years; average disease duration: 19 years; 58% female;  80.9% were not living alone; 83% no formal education or schooling <4 years ; 25% had a previous episode of severe hypoglycemia in the preceding 12 months and 61% were treated in a primary care setting. Regarding drug treatment: 55% on insulin; 32% on a secretagogue; 7% on other oral AHA and 7% on insulin+secretagogue. Missing a meal was the most frequent immediate cause of hypoglycemia (56%). All patients received lab evaluations. 71% underwent radiological procedures. Time spent in the ER was 11 hours (mean) and the average medical and nurse time utilized was 85 and 71 min respectively. AHA therapy was changed in 65% of cases: insulin adjustment (56%) being the most frequent modification. 56% (132) of patients were discharged.  CONCLUSIONS: Diabetic patients admitted to the ER have several markers of frailty and low educational status. Strategies to mitigate hypoglycemia underline the need to avoid missed meals. ER episodes are lengthy and consume significant physician and nurse time as well as laboratory and other diagnostic procedures. Primary care stakeholders should be involved in actions to mitigate hypoglycemia in type 2 diabetes.