Abstract
Background:
Impaired awareness of hypoglycemia (IAH) is an acquired syndrome in people with insulin-treated diabetes, with a diminished or absent ability to perceive the onset of hypoglycemia. It can result in severe hypoglycemia and possibly death. At present, no previous study was performed in Saudi Arabia region to ascertain the IAH prevalence.

Objectives:
The aim of the current study was to investigate the self-reported prevalence of moderate, severe hypoglycemia, and IAH among patient visiting KFMC Obesity Metabolic Endocrine Centre (OEMC) Type 1 and Type 2 diabetics. In addition, we assessed the possible determinants of IAH.

Materials and Methods:
This was an observational cross sectional study conducted on diabetic patients attending outpatient clinics of the OEMC of King Fahd Medical City during a period of 12 months using Clarke questionnaire.

Results:
Findings showed a low prevalence of IAH in the region (13.8%) and that IAH patients had experienced a significantly higher rate of severe hypoglycemia compared to hypoglycemic aware patients. These findings are consistent with the hypothesis that IAH develops mostly in patients with type 1 diabetes (T1D) but also presented in type 2 diabetes (T2D). This remains to place them at risk of experiencing severe hypoglycemia.

Conclusion:
IAH and severe hypoglycemia are relatively common among T1D and T2D patients. Prospective investigations that concentrate particularly on restoring awareness of hypoglycemia are required to promote measures to manage this severe complication of insulin treatment.

Key words: Hypoglycemia; Impaired Awareness of Hypoglycemia; Severe hypoglycemia; Diabetes.