Type 2 diabetes mellitus is a familial disorder that is fast becoming epidemic in the USA. It is possible that nurses will care for entire families with diabetes in the near future. In multiple studies, family functioning, a family systems variable, has been correlated with self-management and glycemic outcomes. Most persons with diabetes live with family members who might facilitate or inhibit self-management tasks or skills. Multiple afflictions of family members with diabetes can further complicate matters relating to diabetes self-management. Diabetes collectively affects over 16 million people in the USA, incurring healthcare costs in excess of 92 billion dollars annually. Individuals engage in self-management behavior for diabetes care in the context of their family's environment. It is imperative that nurses consider factors that might inhibit or facilitate self-management efforts by individuals with type 2 diabetes mellitus. Assessment of family determinants of adaptation to diabetes with appropriate interventions can improve clinical outcomes, subsequently preventing complications.