South Asia's diabetes crisis needs families: how can we advance from informal care to integrated engagement?

Type 2 diabetes (T2D) is an escalating concern in South Asia, with prevalence surging over the past two decades. Family members often significantly influence T2D outcomes and management, yet involvement remains informal, unstructured, and unrecognized within healthcare systems. This viewpoint calls for a more structured, equitable approach to family engagement in T2D care, outlining three models (family-supported, family-wide, and family-led) that can optimize the role of family in T2D care. Given the diversity of household structures, interventions must be adaptable to varying family dynamics. While family involvement can enhance care, challenges such as cultural barriers, gender and age disparities, and inconsistent healthcare guidance must be addressed. Providers need training and clear protocols to engage families, while policies must ensure that caregivers are equipped with adequate support. Digital tools, including social media and telemedicine, offer promising ways to enhance family support in T2D management. Ultimately, South Asia must move beyond reliance on informal care to system-integrated family engagement that recognizes and empowers those often at the frontlines of care.