OBJECTIVES: Hypoglycaemia has negative implications for healthcare resources and diabetes patients’ quality of life. However, there are limited data available on hypoglycaemia in a real-world setting. This study investigated the economic and health-related impact of self-reported non‑severe hypoglycaemic events (NSHE) and severe hypoglycaemic events (SHE) in Spain. METHODS: Patients over the age of 15 with type-1 (T1) or insulin-treated type-2 (T2) diabetes were recruited via existing panels to complete four questionnaires at weekly intervals. Data were collected on frequency of NSHE and SHE, and their impact on patient well-being, work productivity and health care resource use. NSHE was defined as an event which the patient could manage without assistance and SHE as an event needing help from a third party to manage. RESULTS: In total, 630 patients completed 2238 patient-weeks. Mean self‑reported NSHEs per patient week were 1.7 in T1 patients and 0.5 in T2 patients. After their last NSHE, 67% of patients reported feeling tired/fatigued with 45% feeling less alert and 42% feeling ill/uncomfortable. Over the seven days following a NSHE, blood glucose measurement test‑strip use increased by a mean of 5.3. Of the 43% in employment, 18% reported loss of work time due to the last NSHE. A total of 8% of T1 and 20% of T2 patients contacted a health care professional following a daytime NSHE, and 12% (T1) and 20% (T2) following a night-time NSHE. After a SHE, 30% of patients required emergency visits. CONCLUSIONS: Hypoglycaemic events are a common occurrence in T1 and insulin-treated T2 patients in Spain and present an economic burden through increase in health care-resource use and work time loss. They also have a negative impact on patient well‑being. However, the real burden of hypoglycaemia may be underestimated as events are often not reported to a health care professional.