OBJECTIVES: The purpose of this study was to assess the magnitude of hypoglycemia barrier in terms of physician’s treatment choices and algorithm and the impact of hypoglycemia in adherence and persistence to insulin treatment.  METHODS: Four hundred thirteen Turkish physicians were interviewed by close ended questions with a mix of dichotomous or bounded continuous response formats. Questions were asked face to face in 2 national diabetes congresses, with a physician mix of 75% internists, 23% endocrinologists, 1,9% family physicians and rest pediatricians and obstetrics.  RESULTS: Within 413 replies on how important is the hypoglycemia barrier to reach the target HbA1c on an importance scale, 95% replied either important or very important.  82% of physicians declared that they would change their target HbA1c, if they were not concerned about hypoglycemia. Similarly, 88% of physicians believed more of insulin-treated patients might reach target HbA1c if physicians are not concerned about hypoglycemia. Among the physicians replied 79% stated that less than 40% of their patients reported their hypoglycemic status. If patients experience hypoglycemia, 75% of physicians would reduce the insulin dose for more than 60% of patients, 85% would stop insulin treatment for less than 20% of patients, 91% would switch to other insulins and 62% would to prefer to keep same treatment for less than 20% of the patients. Among the physicians replied, 35% of them declared that patients are willing to stop treatment due to hypoglycemia and more than 50% declared that patient needs a new insulin that causes less hypoglycemia. CONCLUSIONS: In this study, physician dimension of hypoglycemia was explored. From the results obtained, it is obvious for the Turkish physicians that hypoglycemia is perceived as a major barrier for the better treatment of the patients. These results show that new treatment options causing less hypoglycemia are needed in the treatment of diabetes mellitus.