Aims: To observe the translation of a peer support pilot study for those with Type 2 diabetes into ongoing peer support activity in three Cambridge general practices. To report on the perceptions and experiences of those participating in and facilitating peer support. Methods: Sixth-one patients with Type 2 diabetes participated in a pilot study for a randomised controlled trial of peer support. Participants were initially randomised to receive peer support delivered as a 1:1 meeting, group session or a combination of both. Subsequently, we allowed cohorts to develop naturalistically and documented this over 18 months. Interviews were carried out with all peer support facilitators and a purposive sample of participants. Ethnographic observation was conducted at relevant sites. Results: The 1:1 intervention evolved into a group intervention and the group intervention drew support from the 1:1 intervention. The remnants of the mixed intervention joined the group intervention. Ethnographic study showed that (1) patients can derive a positive sense of their condition through interaction with others with diabetes through ‘ontological recognition’; (2) discussion of comorbidities was an important part of group bonding processes; (3) group renewal represents a signiﬁcant challenge for peer support; and (4) peer support encourages involvement in wider health spheres, such as GP patient participation groups. Conclusion: Those receiving and facilitating peer support frequently report that it has had a positive impact on their life, that talking with similar others helps them to understand their condition and that it has empowered them to be more proactive in encounters with health services.