Table 1. The work of patients living with type 2 diabetes.

	Patients	Clinicians
Barriers on the health system	Of course, it's not easy, you have to get up very early to get an appointment with the physician. (HC1P5).	I do not know if it is the optimal program [cardiovascular]. A well-controlled patient is seen in three months, and after that, a lot of time passes! (HC1HP2)
	They say, "it's going to be a while because the agenda for the health professionals is replete." (HC2P5)
		On the consultation, you have to write everything down. (documentation for the health center] (HC2HP4)
	It was a year without seen a physician, or the nutritionist, they gave me the medicines every month. . . but I had no consultation. (HC2P4)
		Our system is too rigid, clinical judgment should be more important than a standard protocol! (HC3HP9)
		One must review test results, complications, drugs, lifestyle changes in 30 minutes. I cannot do magic! (HC3HP6)
Relationship with the healthcare team	They [physicians] ask you 'what are you taking?' and when you tell them, they give you the same, and then they call the next patient [not more communication or relationship] (HC1P1)	Health professionals don’t speak the same language and sometimes they contradict each other confusing the patient. (HC2HP1)
	Suddenly we can, not with scientific bases, but with our instinct, discuss with the doctor, before that wasn’t allowed (HC3P5) because the physician was always right! (HC2P3)	Here, the physician is God, whatever they say the patients do. (HC2HP4)
		Patients could skip appointments with the nutritionist or the nurse, but not with the physician, because they give you the medications. (HC3HP10)
	A physician could give you confidence with his kindness and disposition. (HC3P5).
Patient education	They [health team] didn’t explain to me [that I had diabetes]. . . so I didn’t know how to care for myself. I had no idea! (HC1P3)	The time for patient education is very little, that is why we have a growing number of decompensated diabetics. (HC2HP6)
	The greatest difficulty in dealing with the disease is not knowing the symptoms and what to do about them (HC1P2)	There isn’t formal education. I try to explain everything to them, and they seem interested, but it is difficult for them to understand. (HC1HP3)
	[Where is the insulin placed?] In this part [showing]? (HC2P2) No! it is not placed there! (HC2P3) The insulin is placed in the arms and the tummy, here. (HC3P6). There is fat diabetes and skinny diabetes, she has the skinny because she was chubby, and she became thin [laughs] I have fat diabetes because I'm still the same. (HC1P4) [patients educating each other during the focus groups]
		I believe that both the patient and their family should be educated. Patients who have an average level of education and support from their family have better results controlling the disease. (HC3HP8)
Healthy Diet	You can take care of yourself, take the medicines, but the food, no! It is too delicious [everybody laughs and nods]. You cannot leave the food that you love. (HC1P6)	The cultural reality, where bread, dough, flour, is very important. (HC1HP5)
		They spend on soda drinks more than 500 dollars a month! (HC3HP1)
	I still eat everything, beef, pork, sausages. (HC3P4)
		It makes the patient happy to eat something rich with the family, to take that away that, is like taking away their world! (HC2HP7)
	One cannot go to parties, because we have to only talk now, not eat or dance, nothing more. (HC2P3)
		As long as they feel fine [physically], they don’t change their habits. (HC1HP4)
Drug treatment	Before they use to give the patient everything on the physician 's offices [they mention the glucose self-monitoring strips]. Now you have to buy the strips and they last nothing. (HC2P2)	Patients complain a lot about metformin, it is too big, they cannot swallow it or produces gastric intolerances, but there aren’t options! (HC1HP4)
	Metformin is a big tablet and you have to swallow it anyway. (HC1P7).	The way they manage their medicines depends on their health education, otherwise it could be chaos. (HC2HP1)
	Those pills [metformin] are huge. I feel like chocking, every time I try to swallow them [showing with her finger how large the pill is] (HC2P4).	Patients get bored and confused on the right doses, they confuse the colors, they have a hard time reading the labels. (HC3HP7)
	When you start [medicines], you get like weird feeling, but when you stop taking them it also feels strange, like the body asks for the medicine. (HC3P10)
Physical activity	One is told that walking in the house isn’t physical work, you have to walk outside. (HC1P7)	“Doctor, I'm always moving around the house. . .” Every patient says that [Everyone agrees]. (HC1HP1) or they said I walk half an hour to go to take the bus. (HC3HP2).
	I used to walk around before, now the neighborhood is too dangerous, people drinking on the streets or smoking pot, even selling marijuana. (HC2P5)
		Some people are not interested in exercising, others complain about knee or hip osteoarthritis. (HC2HP5)
	[They insist I walk regularly but] I don't feel half of my feet, even if the shoe is good, I do not feel it. (HC3P4)	Some patients attend exercise class at the health center, and it works super well, but the number of members is limited. (HC1HP6)

HC: family health center; HP: Health Provider; P: Patient. e.g., (HC1P5) = Patient 5 at the first family health center.