[Comprehensive care of patients with type 1 diabetes in primary health care: policies, practices, and the role of civil societyAtenção integral a pacientes com diabetes tipo 1 na atenção primária à saúde: políticas, práticas e o papel da sociedade civil].

Objective: Using Mexico as a case study, identify barriers and opportunities and formulate recommendations to strengthen management of type 1 diabetes mellitus (T1DM) in primary health care (PHC), with potential for implementation in other countries of the Region of the Americas. Methods: A two-stage exploratory qualitative study was conducted. The first stage consisted of a scoping review (2010-2020) of the PubMed, LILACS, and SCIELO databases for reports of successful comprehensive care practices for T1DM, classified into four domains: physical health, emotional health, functional, and social. The second stage consisted of semi-structured interviews with the chief executives of 12 civil society organizations (CSOs) in Mexico, to analyze their strategies for intervention, education, and linkage with public policies. Results: The scoping review yielded 12 studies, highlighting continuous glucose monitoring, diabetes education, and psychosocial support as key elements. CSOs in Mexico have developed innovative interventions, despite facing barriers such as a lack of basic supplies, nonstandard protocols, and reliance on external funding. Their interventions have had a relevant impact on improving self-care, access to technologies, and emotional support. Conclusions: The care of patients with T1DM in PHC settings requires a distinct model that combines sustained access to supplies, continuing education, and emotional support. The findings of this study can be used to outline a model adaptable to other countries of the Region of the Americas, based on coordination between the public sector and civil society to improve equity, continuity, and quality of care.