OBJECTIVES To determine current preferences in the use and titration algorithms for insulin, in physicians currently prescribing glargine for adult diabetic patients in Latin America. METHODS A cross-sectional survey was performed to physicians randomly selected based on their country and specialty. The survey collected information about the practice of the physician, use and preference of insulin and titration algorithm for glargine in type 1 diabetics, and in type 2 diabetics, between September and November 2007. RESULTS A total of 649 physicians from 12 countries in Latin America were included in the analysis. Almost one third of glargine prescribers were endrocrinologists, although the distribution by specialty was variable across countries. For people with type 1 diabetes, physicians preferred the use of long-acting insulin (53.8%). Only a few physicians preferred the use of premixed insulin (16.3%). Almost half of the physicians surveyed reported the use of insulin analogs for combinations in these patients. In people with type 2 diabetes, up to 48% of physicians prefer intermediate insulin alone or combined with rapid-acting insulin analogs (31%), or short-acting insulin (18%). There is more homogeneity in the treatment preference across specialties for these patients. Only 20% reported use of premixed insulin. A simple physician driven weekly dose adjustment algorithm was preferred for the titration of insulin glargine (37%). CONCLUSIONS The use of insulin analogs and intensive titration algorithms is more frequent in physicians that treat people with type 1 diabetes; on the other hand, the use of intermediate-acting insulin and conventional management is more frequent in people with type 2 diabetes. Simple weekly dose adjustment algorithms for titration of glargine with low patient participation are most often used in Latin America