While serious games in healthcare have gained much attention in recent years, the pedagogical, social or behavioural frameworks tied to the game elements are still poorly understood. We report the prototyping effort as work-in-progress for a serious social gaming framework for children with diabetes. Motivation theories were combined with child education literature to evaluate potential elements of the framework. Based on the evaluation, we designed cooperation, social comparison and focus on positive achievements as core game elements, and limited the extent of competition. Examining the theoretical foundations that underpin different elements of serious games promises a greater understanding of effective gaming techniques for healthcare.