Objective Considering health literacy is a key element for health service responsiveness to self-management needs in diabetes. This qualitative study aimed to provide a detailed analysis of the health literacy of people with type 2 diabetes in relation to their daily self-care practices. Methods Interviews (n=86) were conducted as part of the qualitative study ERMIES-ethnosocio, at the beginning and at the end of a structured educational care. The interviews focused on food practices, exercise, treatment, relationship to health information and professionals. Results Three poles structured into eight themes characterized practices in context: health knowledge, disease management, expertise and social support. The relationships of participants in each of the eight themes were differentiated, ranging from functional to interactive and critical. Treatment and follow-up were essentially functional, while diet and exercise remained more interactive. Social support and relationship to health professionals were important determinants of disease management. Conclusion and Practice implications Treatment management and disease monitoring remain primarily the job of health professionals, as opposed to diet, physical activity and social support being part of ordinary practice. Decision-making, as a shared social task, as well as resources for participation in health services, should be considered for relevant interventions in type 2 diabetes.