OBJECTIVES: Hypoglycaemia is a common complication of insulin therapy and can impede optimal diabetes management, with implications for patients and health care resourcing. Many patients with Type-2 diabetes mellitus (T2DM) use premixed insulin regimens, but data on frequency and impact of hypoglycaemia in these patients are limited outside clinical trials. METHODS: A total of 3827 insulin-treated patients in Austria, Denmark, Finland, Norway, Netherlands, Sweden and Switzerland were recruited, mainly via online panels, to complete four questionnaires at week-intervals. Data were collected on demographics and non-severe hypoglycaemic events (NSHE) in the preceding seven days. NSHE was an event with symptoms of hypoglycaemia, with or without blood glucose measurement (BGM), or low BGM (≤55 mg/dl) without symptoms, which the patient managed without assistance. Severe hypoglycaemic events (SHE) — defined as events requiring third-party assistance — were also reported. RESULTS: The 258 T2DM patients on premixed insulin reported 826 patient-weeks. Mean insulin‑treatment duration was 7 years, mean HbA1c7.9% (SD 1.6). Mean self‑reported NSHEs were 0.52 per patient-week (SD 1.15), 33% of which were nocturnal (versus 23% in overall study). Mean annual frequency of SHEs was 0.2. Impaired awareness or unawareness of hypoglycaemia (answering ‘usually/sometimes/never’ to question ‘can you feel when your blood sugar is low?’) was reported in 57% (versus 63% in overall study). Of the 36% employed, 5% reported lost work time due to the last NSHE. Mean increase in BG test‑strips was 3.2 over the 7 days following each NSHE. Nine percent of patients contacted a healthcare professional following a daytime, 10% following nocturnal NSHE. CONCLUSIONS: NSHE are common amongst premixed-insulin-treated T2DM patients; a third occurring at nighttime. NSHE were associated with work time loss and increased health care resource use, however hypoglycaemia awareness was low, and events not often reported to patients’ GP/specialist. The real‑world rates — and burden — of hypoglycaemia may therefore be underestimated.