Beyond the Prescription: How Bullying and Social Networks Affect Device Use in Youth with Type 1 Diabetes

Getting an insulin pump or continuous glucose monitor (CGM) is a major step in Type 1 diabetes management—but only if a young person can actually use it every day, at school, and in public. A new study of 50 youth with Type 1 diabetes and 56 of their caregivers reveals that racial and socioeconomic disparities don't stop at prescription. Instead, they shape whether young people feel safe and supported enough to keep using these devices.

Researchers compared the experiences of higher-income, primarily White youth with Type 1 diabetes to those of lower-income youth, and youth of color—predominantly Latinx and Black. While both groups faced some similar challenges, the study uncovered two striking differences that highlight hidden inequities in device use.

Lower-income youth and youth of color with Type 1 diabetes reported significantly more fear and bullying related to their devices at school. This isn't a minor inconvenience—the study found that bullying and victimization can lead young people to stop using their pumps or CGMs altogether.

When a young person chooses to discontinue their device because of bullying or social rejection, they lose the health benefits that device provides. This creates a real gap in care quality based not on medical need, but on social environment and safety.

The second major finding involved social connections. Lower-income youth and youth of color with Type 1 diabetes reported having fewer connections to other families managing Type 1 diabetes. Instead, they had more connections to people with Type 2 diabetes.

This matters because it shapes how others—and sometimes the youth themselves—perceive their disease. When peers and community members mostly know about Type 2 diabetes, they may assume that a young person with diabetes has Type 2. This misunderstanding carries significant stigma and misconceptions. More importantly, it means these young people miss out on the support, practical advice, and solidarity that comes from connecting with other families living with Type 1 diabetes specifically.

Researchers called this missing connection a loss of 'diabetes-related social capital'—the knowledge, support, and understanding within a community that can make managing a condition easier and less isolating.

This research shows that health inequities in device use are about more than money or access to doctors. They involve bullying, social isolation, stigma, and the simple fact that some young people have communities of support while others don't.

Addressing these disparities will require attention to the social environment—school safety and inclusion, community support networks, and ensuring that all youth with Type 1 diabetes can connect with peers who understand their condition. Device access is necessary, but it's not sufficient on its own.

Source: SSM. Qualitative research in health. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.