Paper Short Abstract:

Drawing on two cases of local health services (Brazil and the United States), we explore how health professionals develop educational processes for promoting self-managemet among people with diabetes, try to explain why those programmes fail and show how users look for alternative ways of self-care.

Paper Abstract:

According to the International Diabetes Federation, diabetes is “a pandemic of unprecedented magnitude” now affecting one in ten adults worldwide (IDF, 2021). An adequate self-management plays a key role in its treatment. Nevertheless, diabetes self-management is a hard goal for people suffering the disease and an educational challenge for health teams. Health professionals must lead successful educational processes, but social research has also shown that they often become a crucial barrier for self-management due to diverse causes (lack of interdisciplinary teams, prejudices, individualist bias…) (Usman & Pamungkas, 2018). In this paper, we try to better understand the processes of formal education for diabetes self-management through the comparison of two cases: one located in the Global North (a private hospital in Massachusetts, USA), the other in the Global South (a public Family Health Support Center in Minas Gerais, Brazil). In both cases, we find a clear gap between programmes’ aims and real implementation, as well as a biologicist approach that leads to identify certain biomedical parameters (basically, A1c, Body Mass Index and carbo-hydrates intake) as the main factors regarding therapeutic and educational proposals. Both cases are caractherised by professionals with lack of knowledge about patients’ social background and everyday habits, resulting in unsuccessful health providing practices. In this context, the users of both health systems autonomously search alternative learning ways and develop bricolage practices of self-management.