Impaired Awareness of Hypoglycemia (IAH) is associated with Severe Hypoglycemia (SH). This study investigated the actual state of hypoglycemia, including IAH, in patients with Type 2 Diabetes. A questionnaire survey on hypoglycemia and patientphysician communication was conducted in 331 patients with insulin-treated Type 2 Diabetes patients at 16 hospitals and clinics. The rate of IAH was 22.1%. Glycemic control at an HbA1c level <7.0% was a significant risk factor of IAH (odds ratio (OR): 2.12; 95% Confidence Interval (CI): 1.22-3.68; P =0.01), along with a male sex and lower body mass index. Concerning talking about hypoglycemia with physicians, patients with IAH showed a similar frequency of talking with physicians as patients without IAH, while patients with SH communicated more frequently than those without SH. Considering the prevalence of IAH, physicians should be conscious of the IAH-associated factors and talk more about hypoglycemia.