Implications for practice and research

• Understanding the family dynamics is crucial to improve diabetes management.

• Family members can both support and sabotage the patient's self-management efforts.

Context

Adults with type 2 diabetes see their physician more often than most other patients. National survey data indicate that the typical patient with diabetes will have seven to nine appointments in a year with their primary provider and additional visits with specialists, nurses and educators.1 Added together over the course of a year clinical care interactions represent <1% of an individual's daily life. For the other 99% of the time, people must self-manage their disease within the context of their families, workplaces and communities. …