Diabetes-related bullying in school

Daniel Sher discusses the impact that diabetes-related bullying can have and how therapy can help empower a child in this position.

Children and adolescents who have diabetes are more likely to experience diabetes-related bullying. This can lead to some serious mental health issues, as well as negatively affecting their diabetes management and overall well-being.

Meet Siya

Siya (not his real name) was diagnosed with T1DM when he was 11-years-old. His parents brought him to see me when he was 14. They were worried that he seemed sad and withdrawn and that he wasn’t willing to help them understand why.

Once Siya felt that he could trust me and the confidentiality of the space, Siya began to open-up. It turned out that once he had moved to a new high school, his peers started to mock and tease him about his diabetes.

The bullying really was relentless. Every time he scanned his CGM or adjusted his insulin dose, this would attract the attention of his peers. Their nasty comments would make him feel ashamed and angry.

He would frequently sit through class with symptoms of high blood glucose, rather than take his insulin. Apart from wreaking havoc with his HbA1c and emotional well-being, Siya’s grades started to drop rapidly, as the high blood-glucose stopped him from being able to focus properly.

More than just bullying 

Discrimination is the unjust or prejudicial treatment of different categories of people based on what makes them different. When somebody is denied a job opportunity because of their gender, for example, this is a clear example of discrimination.

If Siya is being bullied and ostracised because of his diabetes, isn’t this a case of discrimination? The answer is yes; and to support kids like Siya we, as adults, need to start calling a spade a spade.

Calling a spade a spade

When Siya came to see me, he had been ashamed to raise the issue of bullying with his parents or teachers. He didn’t want to be labelled as a tattle-tale. He also didn’t want to “make a big deal out of something that happens to other people every day.”

A part of his treatment involved helping Siya to name and identify what was happening as being both bullying and discrimination. This helped him to understand the seriousness of what was going on. Most importantly, this made Siya feel confident enough to act by raising the issue with his teachers.

Many kids like Siya think that this is “just bullying” and that they need to simply get over it. It’s important for us to recognise, however, that this sort of discrimination, when it happens to people with diabetes, can worsen their blood-glucose control and emotional well-being.

What is the impact of diabetes-related bullying?

Research tells us what we all know intuitively: bullying can lead to some serious mental health consequences. These include:

  • Depression
  • Panic attacks
  • Low self-esteem
  • Impaired concentration
  • Social anxiety
  • Poor peer relationships
  • Missing out on opportunities for social development
  • Greater chances of developing depression in adulthood.

The fact that kids who get bullied are at risk of experiencing these sorts of outcomes means that for those with diabetes, in particular, bullying needs to be addressed. This is because having these sorts of psychological difficulties, over and above having diabetes, can make it that much harder to effectively manage one’s physical health.

Other ways in which diabetes-related bullying negatively affects T1DMs

As was the case with Siya: people with diabetes might end up skipping tests or injections, to avoid attracting attention to themselves. Alternatively, they might be more likely to eat things which are not conducive to their health (and without making appropriate corrections) when they are out in public, to feel more “normal”.

Furthermore, the stress that bullying causes triggers a cascade of hormones in the bloodstream which can raise blood glucose. Kids who are chronically stressed are also more likely to eat sugary snacks which can bring them a moment of comfort and calm amidst the chaos.

How can therapy help?

It seems strange to even suggest that your child who is being bullied should see a therapist, given that the problem clearly lies with the person doing the bullying.

Nonetheless, therapy can provide a valuable space for a child or adolescent who has been bullied to build resilience and learn how to assert themselves constructively.

In my own work with Type 1s who are bullied, a space is provided in which they become self-empowered to take decisive action against bullies. Different forms of practical action are appropriate for different types of bullying. What’s vital here, however, is that we focus on helping to empower a child to take control. Why?

Quite simply, bullying makes a person feel powerless. Having uncontrolled diabetes also makes a person feel powerless. People with diabetes need the right support so that they can take responsibility for themselves. The same applies for children with diabetes who are being bullied.

As parents (or therapists, for that matter), the impulse is often to “swoop-in” and help. Often, depending on the impact of the bullying and the age of the child, this is necessary. To do so without fostering a sense of empowerment and autonomy in your child at the same time, however, is to do them a disservice.

Therapy can also help to:

  • Foster personal growth. This involves developing an understanding that bullies are not bad people: they are simply emotionally and psychologically wounded. As a result, they need to inflict pain to process their own sense of inadequacy. The implication here is that fighting back is not the answer. The best way to deal with bullies is through firm boundaries and an attitude of empathy.
  • Helping kids to understand and regulate the emotions which they experience because of bullying. For children with T1DM it is valuable to confront and take ownership of the sense of “otherness” (i.e. of being different) that gets elicited when others bully them about their diabetes. This is an important aspect of personality development for us; and when we make peace with our fears of being different, we are better able to thrive with diabetes.
  • Finally, therapy helps to bolster children’s self-esteem by showing them that they are neither alone nor powerless.

Summing up

Research has shown that children and adolescents with Type 1 diabetes are victimised by their classmates more often than people who don’t have diabetes. As if people with diabetes didn’t already have enough to worry about!

Unfortunately, bullying can cause an emotional response in children with diabetes that makes it harder for them to thrive with their self-management. Therefore diabetes-related bullying needs to be addressed as a priority.

Not sure how best to manage? Reach out to your doctor and request a referral to a counsellor or psychologist who can provide the right support.


Ando, M., Asakura, T., & Simons-Morton, B. (2005). Psychosocial influences on physical, verbal, and indirect bullying among Japanese early adolescents. The Journal of Early Adolescence, 25(3), 268-297.

Nascimento Andrade, C. J., & Alves, C. D. A. D. (2019). Relationship between bullying and type 1 diabetes mellitus in children and adolescents: a systematic review. Jornal de Pediatria, 95(5), 509-518.


Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital in Cape Town where he works with Type 1 and Type 2 diabetes to help them thrive. Visit www.danielshertherapy.com

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Tips to get your kids eating healthy

The Heart and Stroke Foundation suggests five ways to get your kids eating healthy to support their growth and development, all while building healthy eating habits.

The COVID-19 outbreak is upending life for families around the world. To make things even harder, panic buying and disruptions to food supply systems mean some foods can now be difficult to find. And for many people, unemployment and lost income are making food shopping an additional financial challenge.

While many parents are understandably looking to ready meals and processed foods as a quick and low-cost way to feed the family, there are convenient, affordable and healthy alternatives to get your kids eating healthy.

Five healthy eating tips

  1. Keep up fruit and vegetable intake

Purchasing, storing and cooking fresh vegetables can be challenging. But it’s important to ensure children are getting plenty of fruit and vegetables in their diet. Whenever it’s possible to get hold of fresh produce, do so.

As well as being eaten fresh, vegetables can be frozen where possible and will retain most of their nutrients and flavour.

Using fresh vegetables to cook large batches of soups, stews or other dishes will make them last longer and provide meal options for a few days. These can also be frozen where possible and then quickly reheated.

  1. Use healthy dried or canned alternatives when fresh produce isn’t available

Fresh produce is almost always the best option, but when it’s not available there are plenty of healthy alternatives that are easy to store and prepare.

Canned beans and chickpeas, which are high in protein and fibre, can be stored for months and can be included in meals in many ways. Canned oily fish, such as sardines, pilchards and tuna, are rich in essential omega 3 fatty acids and a range of vitamins and minerals. These can be used cold in sandwiches, salads or pasta dishes, or cooked as part of a warm meal.

Dried goods like dried beans, pulses and grains, such as lentils, split peas, rice, couscous or quinoa, are nutritious, long-lasting options that are tasty, affordable and filling. Rolled oats cooked with milk or water can serve as an excellent breakfast option.

  1. Build up a stock of healthy snacks

Children often need to eat a snack or two during the day to keep them going. Rather than giving kids sweets or salty snacks, opt for healthier options like unsalted nuts, low-fat plain yoghurt, chopped fruit and boiled eggs. These foods are nutritious, more filling, and help build healthy eating habits that last a lifetime.

  1. Limit highly processed foods 

While using fresh produce may not always be possible, try to limit the amount of highly processed foods in your shopping basket. Ready-to-eat meals, packaged snacks and desserts are often high in saturated fat, sugars and salt.

Remember when shopping, always look out for the Heart Mark and DSA logos to help you choose healthier food options for you and your family.

  1. Make cooking and eating a fun and meaningful part of your family routine

Cooking and eating together is a great way to create healthy routines, strengthen family bonds and have fun. Wherever you can, involve your children in food preparation.

Five lunchbox menus to get you started

1. Quick and easy

  • Cheddar cheese cubes
  • Mini whole-wheat rice crackers
  • Apple slices

2. Sandwich option

  • Hard boiled eggs
  • Whole-wheat bread
  • Baby carrots

3. Salad option

  • Tuna pasta salad
  • Sliced orange

4. Vegetarian option

  • Hummus
  • Whole-wheat pita
  • Tomatoes
  • Cucumbers

5. Funky Friday option

  • Peanut butter (no added sugar)
  • ½ banana
  • Sliced apple
  • Low-fat plain white yoghurt

For more healthy, tasty recipes, download our Cooking from the Heart recipe books onetwo, and three from our website.


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