Diabetes demands a lot: constant self-management, new medications and technologies, behaviour changes, and an increased risk for long-term complications. When a child is diagnosed with diabetes, its impacts can also fall on parents and caregivers, who often provide much of the self-management, especially in younger children. It also impacts siblings, who may find themselves struggling to adapt.
Thankfully, there are amazing healthcare teams, diabetes care and education specialists, community groups, and resources that can help provide support, guidance, and helpful information for families going through this transition.
The key to this is making sure the focus isn’t just on how diabetes impacts people’s physical health or health-seeking behaviours, but also how it affects people’s mental health.
It’s well-known that people living with diabetes are at an increased risk for diabetes distress, depression, anxiety, and stress. While research is more limited, we also know that diabetes can negatively affect the mental health of caregivers, parents, and siblings as well. This is why it is so important for the entire family to make sure they are taking steps to protect their mental health and look out for each other. This includes everything from recognizing when a child is experiencing diabetes distress to using tools to prevent caregiver and sibling burnout.
During the 2026 Diabetes + Mental Health Conference, psychologists, advocates, and researchers highlighted not just the mental health challenges that children and teens living with diabetes face, but the challenges that may affect their family members as well. The good news is, there are ways for healthcare teams and loved ones to spot and manage mental health challenges as they arise.
Parent and caregiver burnout
Oftentimes, parents or caregivers take on the majority of diabetes self-management tasks for a child who has been diagnosed. Whether it’s glucose checks, insulin administration, or carb counting, these tasks can often feel overwhelming and exhausting – especially when your child’s health is at stake. Understandably, this can lead to diabetes distress and even burnout in parents.
Diabetes distress refers to the diabetes-specific emotional burden related to things such as a fear of complications, daily management demands, and feeling overwhelmed. Diabetes burnout, on the other hand, is a state of emotional, mental, and physical exhaustion resulting from prolonged stress and diabetes distress that can lead to disengagement or reduced coping.
Research suggests that over 3 in 4 caregivers report psychological distress, and 41% report moderate-to-severe caregiver burden. This type of distress or burnout can take on a number of forms and impact families in multiple ways.
Lacee Musgrove, a licensed clinical social worker who specializes in therapy for children and teens living with diabetes, explained that when caregivers experience burnout, it can negatively impact:
- Diabetes self-management safety (e.g., caregiver fatigue could lead to slower recognition of highs and lows)
- Diabetes self-management consistency (e.g., missed glucose checks or insulin doses)
- Emotional climate in the household (e.g., increased household tensions)
- Modelling behaviours (e.g., children began to adopt or internalize their parents’ stress and coping patterns)
- Family systems (e.g., siblings might feel overlooked, increased tension with partners, and disrupted family routines)
Musgrove stressed that caregiver burnout is common and nothing to be ashamed of.
“If this is you, I want you to know you are not alone and there is a whole community out there that can support you," she said. "The good news is that burnout is preventable and treatable. The better news is you don't have to be perfect. All parents need to do is try their best to be there for their child."
When caregivers receive mental health support, it can improve the child’s mental health outcomes, lead to stronger family functioning, and allow for more sustainable diabetes care.
There are lots of practical strategies that caregivers can use to help reduce or prevent distress and burnout. For example, it’s important for caregivers to normalize their own emotions and keep an eye out for early warning signs. Musgrove emphasized the importance of making space for feelings like exhaustion or frustration, while also keeping an eye out for signs of more severe burnout, such as persistent irritability, emotional numbness, and skipping meals or sleep.
She also encouraged caregivers to prioritize small breaks and their own self-care whenever possible. When it comes to those short pauses that restore energy and resilience, this might mean relying on a partner to help split up diabetes care or encouraging the child to participate in age-appropriate self-management tasks. Regarding self-care, don’t underestimate the power of mental health support in the form of therapy, support groups, and connecting with other parents online. Being able to relate to others and share stories of success and frustration can help caregivers feel less alone.
It’s important to remember that what works for one person may not work for another, so try out multiple strategies to see which works best for you and your family.
Tips for helping siblings adjust
One area where there’s still not a ton of information is how diabetes impacts siblings.
An important concept in this topic is something called adjustment. Adjustment refers to the challenges, growth, and resilience that accompany a diagnosis. The adjustment period lasts, on average, about 1-4 months for a child who is diagnosed and 6-12 months for caregivers or parents, but it’s not known what the adjustment period is for siblings.
What experts do know is that there are several factors associated with reduced sibling adjustment, including being older in age, being exposed to higher levels of parenting stress, a child’s temperament, poor adjustment for the sibling living with diabetes, and negative perceptions about diabetes or its impact on the family. Notably, 30-38% of siblings in studies report significant emotional and behavioural problems related to coping with the impact of type 1 diabetes on the family.
Taylor Stephens, a paediatric psychologist with the Cleveland Clinic, and Meg Snyder, a paediatric psychologist with the Kennedy Krieger Institute and the Johns Hopkins Paediatric Diabetes Center, explained that there are a number of signs that can present when a sibling is experiencing adjustment difficulties. These can look different depending on the sibling’s age.
For example, in very young children (0-6 years), adjustment difficulties might look like tantrums, separation anxiety, confusion, or attention-seeking behaviour. In school-aged children (7-10 years), it might include negative emotions around diabetes tasks or their sibling with diabetes, challenging or negative behaviours or verbal expressions, or a shifting relationship with their sibling with diabetes. In pre-teens and teens (11-18 years), it can present as increased anxiety or worry, withdrawn behaviours or irritability, downplaying concerns, mimicking parental behaviour, and seeking increased time away from home.
If there are adjustment difficulties, it’s important for parents and caregivers to remember that big feelings are expected and welcome with something as major as a diabetes diagnosis and that learning about diabetes can help with a sibling’s adjustment.
“We know that adjustment is hard, but it is temporary. It ebbs and flows and is not always linear,” said Stephens.
Stephens and Snyder provided some tips for helping siblings adjust. One strategy is best described as encourage, prepare, talk, and teach:
- Encourage siblings to ask questions about diabetes from a place of curiosity.
- Prepare them in advance when big changes or transitions to their routine are coming up.
- Talk about feelings without assigning judgment to whether an emotion is “good” or “bad.”
- Teach them about what diabetes is and how it’s managed.
Other important strategies that the experts highlighted focused on helping strengthen a sibling’s relationship to their brother or sister living with diabetes and also to their parents or caregivers.
“Aim for honest and shared growth together as a family while also promoting childhood,” said Stephens.
This might look like making sure that neither the child with diabetes nor the sibling without it feels underappreciated, isolated, or singled out. Some ways to do this include helping the sibling engage in their brother or sister’s diabetes management tasks as appropriate, making sure that the entire family makes changes together, finding ways to connect the whole family with the diabetes community, and making sure that each child receives appropriate one-on-one time with their parents and is celebrated for their unique strengths equally.
Mental health resources for the entire family
Managing diabetes is hard, but with the right coping strategies and support, children and teens who receive a diabetes diagnosis, as well as their family members, can all protect their mental health.
If you are living with diabetes or have a loved one or child living with diabetes, here are some helpful mental health resources:
