An ongoing initiative of the Pan American Health Organization/World Health Organization focuses on the development of basic procedures to improve diabetes prevention and control: the Building Blocks project. A set of diabetes care guidelines based on the Building Blocks principles resulted from a number of regional workshops involving experts in a variety of diabetes-related fields from across the Americas. These guidelines can be adapted and applied effectively depending on the health scenario – the available technical capabilities and resources – in a country or region. The scenarios described in the Building Blocks approach range from the minimal (Scenario 1) to the ideal (Scenario 3) and centre on three areas: clinical management, diabetes education, and nutrition. Felicia Cañete and Alberto Barceló report from Paraguay on the first pilot of the Building Blocks project.