Aim: The purpose of this study was to examine adherence to hypoglycaemia treatment guidelines in adults with type 1 diabetes (T1DM). The American Diabetes Association recommends consumption of 15–20 g of glucose to treat hypoglycaemia. Overtreatment may result in poor glycaemic control and greater glycaemic variability. It is not fully understood how well T1DM adults comply with hypoglycaemia treatment recommendations. Design:A secondary analysis using a descriptive comparative design. Methods: Using real‐time measures over six consecutive days, we examined (a) adherence to hypoglycaemia treatment guidelines and (b) comparisons of demographic self‐management behaviour, psychological characteristics and glycaemia between adherent and non‐adherent groups. Results:Findings revealed those who overtreated consumed more daily grain servings and reported higher stress and depressed mood compared with those who fol‐lowed treatment recommendations. Findings suggest that hypoglycaemia treatment practices and psychological factors influencing self‐management should be assessed.