Lay summary
In the Western world and New Zealand diabetes guidelines, an individual is expected to take control of their own food choices. For Tongans, what is neglected is the consideration of family background, household dynamic and community involvement. Family-based approach is a collective effort. Food choices are determined by various factors including family food preferences and food availability, who makes the decision about what to buy, what to prepare, who prepares and cooks food, cooking skills and cooking methods, what to eat at what time, and what matters when food is served for the person in the family with diabetes. The food choices of one person within the family is under a complex set of influences. This is the root of the difficulty. Being Tongan with diabetes means that, as an individual, one struggles with what matters to the family, and this shapes the experiences of Tongans with diabetes.