OBJECTIVE: To assess patient perspective on hypoglycemia in patients with type 2 diabetes taking oral hypoglycemic agents (OHAs). METHODS: A questionnaire was developed to explore the subjects' perception and knowledge of hypoglycemia, including frequency and severity of symptoms. We also assessed the potential relationship of hypoglycemia to OHAs. Thirty-one study subjects with Type 2 diabetes and at least 30 years of age responded to advertisements to participate in this study. Patients were distributed in three groups according to age and previous experience of hypoglycemia: Group 1: older patients with hypoglycemia experience, Group 2: patients without previous hypoglycemia and Group 3: adults with previous hypoglycemia. Patients completed a questionnaire and then took part in a moderated focus group. RESULTS: Eight subjects in Group 1 (mean age 66.4 ± 2.8 years old) and 12 patients in Group 3 (mean age 52.7 ± 6.4 years old) reported experiencing hypoglycemia; while 12 patients in Group 2 (mean age 56.8 ± 6.8 years old) reported, "not experiencing hypoglycemia" in the past. Patients completed the questionnaire and then participated in a moderated focus group. Less than 25% of Group 1 and 2 patients recognized the symptoms of hypoglycemia. Approximately 27% of patients in Group 2 experienced these symptoms but none recognized they were manifestations of hypoglycemia and 18% reported that they experienced trembling very often or always. None of the subjects connected these symptoms with their antidiabetic medications. All patients in Group 1 seemed to be surprised that OHAs have side effects. Approximately 25% of patients gave a wrong definition of hypoglycemia in their questionnaires. CONCLUSIONS: There seems to be a large information gap about hypoglycemia. Patient and provider education is needed to help patients to understand what hypoglycemia is or recognize the symptoms of hypoglycemia.