However, there are a number of limitations to this study that need to be acknowledged. First, some ambulance call-outs may not have been captured, as only patients who have been recorded are analysed and therefore our data may underestimate the size of the problem. Second, some data were missing in a minority of patients, a known disadvantage of such observational studies. Third, the causes of death and various comorbidities in these patients have not been documented in this work. For example, information regarding comorbidities would help clarify the potential role of hypoglycemia in mortality or may simply indicate that low glucose levels are a marker of early demise in patients with diabetes. Finally, there are known limitations with the accuracy of CBG measurements as the patients may have been hypoglycemic for different periods of time before calling for an ambulance, and the CBG meters can also be inaccurate, especially when recording very low glucose readings. The use of the CBG values does, however, confirm that all the episodes included were genuine hypoglycemic events.

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