['The purpose of this study was to investigate the clinical epidemiology of severe out-of-hospital hypoglycaemia, to evaluate the standard treatment protocol used, to investigate the clinical outcome during a 3-month follow-up period and to evaluate financial savings achieved by not transporting all patients to hospital.', 'This study was a prospective, observational study based on questionnaires and patient files. Two paramedic units of the Rescue Department filled in a study form on each hypoglycaemia patient they enrolled between 1 February 2001 and 31 December 2001. These patients were contacted by mail after 3 months and asked to fill in a questionnaire regarding their health.', 'Sixty-nine patients were included in the study. The majority of the patients had diabetes mellitus for more than 5 years. The severity of hypoglycaemia was related to the duration of diabetes (P = 0.003) and insulin therapy (P = 0.021). Fifty-eight patients (84.1%) required intravenous glucose treatment. Sixty-two patients (89.9%) were left at the scene after treatment. No immediate relapses occurred. Mean patient satisfaction was 4.6 (SD 0.8) on a scale from 1 to 5. Satisfaction was related to the duration of diabetes (P<0.0001) and to low haemoglobin A1c values (P<0.0001). The direct savings achieved by not transporting the patient to the hospital emergency department were estimated to be 398.5 per patient.'] Is out-of-hospital hypoglycaemia safely and cost-effectively treated by paramedics?