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In this study we apply the principles of patient-centred care to assess how health systems in middle income countries shape the experiences of patients with a common chronic disease and their care providers. We conducted semi-structured interviews with patients with diabetes, health professionals and key informants. We selected interviewees by purposive and snowball sampling. In total 340 respondents were interviewed in five countries: Armenia, Belarus, Moldova, Russia and Ukraine. Data were analysed according to a coding framework that was developed by three researchers, who then uncovered salient themes, similarities and differences between the five countries. Access to and consistent use of services was hampered by the lack of coordination and the financial weaknesses in the health systems. In many cases, lack of external support for individual patients left friends and family as the main providers …