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While hypoglycaemia is defined as a blood glucose level under 70\u2009mg\/dL (3.9\u2009mmol\/L), symptoms may occur at higher blood glucose levels in individuals with poor glycaemic control. Severe hypoglycaemia is defined as an episode requiring the assistance of another person to actively administer carbohydrate, glucagon, or take other corrective actions to assure neurologic recovery. Hypoglycaemia is the most important safety outcome in clinical studies of glucose lowering agents. The American Diabetes Association Standards of Medical Care recommends that a management protocol for hypoglycaemia should be designed and implemented by every hospital, along with a clear prevention and treatment plan. A tailored approach, using clinical and pathophysiologic disease stratification, can help individualize glycaemic goals and promote new therapies to improve quality of life of patients. Data from recent large clinical trials reported low risk of hypoglycaemic events with the use of newer anti\u2010diabetic drugs. Increased hypoglycaemia risk is observed with the use of insulin and\/or sulphonylureas. Vulnerable patients with T2D at dual risk of severe hypoglycaemia and cardiovascular outcomes show features of \u201cfrailty.\u201d Many of such patients may be better treated by the use of GLP\u20101 receptor agonists or SGLT2 inhibitors rather than insulin. Continuous glucose monitoring (CGM) should be considered for all individuals with increased risk for hypoglycaemia, impaired hypoglycaemia awareness, frequent nocturnal hypoglycaemia and with history of severe hypoglycaemia. Patients with impaired awareness of hypoglycaemia benefit from real\u2010time CGM. The diabetes educator is an invaluable resource and can devote the time needed to thoroughly educate the individual to reduce the risk of hypoglycaemia and integrate the information within the entire construct of diabetes self\u2010management. Conversations about hypoglycaemia facilitated by a healthcare professional may reduce the burden and fear of hypoglycaemia among patients with diabetes and their family members. Optimizing insulin doses and carbohydrate intake, in addition to a short warm up before or after the physical activity sessions may help avoiding hypoglycaemia. Several therapeutic considerations are important to reduce hypoglycaemia risk during pregnancy including administration of rapid\u2010acting insulin analogues rather than human insulin, pre\u2010conception initiation of insulin analogues, and immediate postpartum insulin dose reduction.<\/jats:p>","DOI":"10.1002\/dmrr.3332","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T15:11:01Z","timestamp":1588086661000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Hypoglycaemia and its management in primary care setting"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4460-9849","authenticated-orcid":false,"given":"Mahmoud","family":"Ibrahim","sequence":"first","affiliation":[{"name":"EDC Center for Diabetes Education McDonough Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0837-1143","authenticated-orcid":false,"given":"Jason","family":"Baker","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7830-9994","authenticated-orcid":false,"given":"Avivit","family":"Cahn","sequence":"additional","affiliation":[{"name":"The Diabetes Unit &amp; Endocrinology and Metabolism Unit Hadassah Hebrew University Hospital Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Eckel","sequence":"additional","affiliation":[{"name":"University of Colorado Denver Anschutz Medical Campus and University of Colorado Hospital Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuha Ali","family":"El Sayed","sequence":"additional","affiliation":[{"name":"Joslin Diabetes Center Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Hess","family":"Fischl","sequence":"additional","affiliation":[{"name":"University of Chicago Kovler Diabetes Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gaede","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Endocrinology Slagelse Hospital Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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