(LifeWire) -- Cherie Cruse was devastated when she learned in 2003 that her 4-year-old son Andrew had juvenile diabetes.
Andrew Cruse uses an insulin pump and checks his blood sugar levels, even when he is playing football for the Kennett-Unionville Titans.
"It was like someone knocked the life out of me," she said. "I had no idea at the time what a huge impact diabetes would have, not just on Andrew, but on our entire family."
Anne Chaffin had a similar reaction nine years ago when her daughter, Evyn, then 8, was diagnosed with diabetes "All of a sudden, your idea of perfect health is gone."
Diabetes, which is characterized by higher-than-normal blood sugar levels, is a lifelong condition. It pervades every aspect of childhood and makes a typically challenging path through adolescence all the more difficult. How to manage diabetes »
Hypodermic needles and injections, usually the stuff of annual flu shots and periodic vaccinations, become a daily trial with routine blood sugar testing and insulin shots.
For parents like Chaffin and Cruse, having a young child with type 1 diabetes (also known as juvenile diabetes) thrusts them into a complicated and confusing world of diagnosis, medication and assuming many of the daily tasks of diabetes management, while they wait for their children to be ready to take on more of the responsibility for their care.
"I'll never forget the first time I had to do (Andrew's) injection," recalls Cruse, 37, of Kennett Square, Pennsylvania. "He scooted up to the head of his bed, holding on to the headboard for dear life, begging me, 'Please, mommy, don't do it. Please, mommy, no'."
Managing the disease
After Andrew's diagnosis, Cruse would sit outside his preschool for three hours every day, worried that he might have a low blood sugar emergency. Today, Andrew, 9, is in third grade, and she no longer waits outside his school, although she and her husband still keep an eye on him during sporting events.
Andrew now knows how to check his blood sugar levels and how to treat the highs and lows. A pump that automatically injects insulin into his body helps him avoid the extreme changes in blood sugar levels that can come with playing sports, although he often needs extra carbohydrates before, during and after football and baseball practices.
"Every child is different, and will be ready for responsibility at different times," says Dr. Grafton D. Reeves, division chief of pediatric endocrinology at A.I. DuPont Children's Hospital in Wilmington, Delaware.
Although type 1 diabetes is still the most common form of diabetes in children, Reeves is seeing more cases of type 2 diabetes, particularly in adolescents who are overweight. He estimates that of the approximately 20,000 new cases of diabetes each year in children and adolescents, approximately 20 percent are type 2 diabetes.
Type 1 diabetes is an autoimmune disease that requires insulin injections, since the body cannot produce insulin on its own. Type 2 diabetes, in which the body either does not produce enough insulin or is not sensitive enough to the insulin it does produce, can be managed through lifestyle changes.
"The most important thing for parents to know is that type 2 diabetes is a preventable disease," says Reeves. If parents work with obese children to lose weight on a medically supervised plan, they can keep diabetes from manifesting."
Dietary limitations, blood sugar checks and insulin injections set children with diabetes apart from their peers. During childhood, when social acceptance is critically important, anything that draws unwanted attention to a child can result in emotional stress and feelings of isolation.
Now 17, Evyn Chaffin, of Landenberg, Pennsylvania, recalls that, "One of the hardest things about having diabetes as a younger child was being different. No one wants anything to make them stand out as a child, and having to take blood sugar readings and inject myself with insulin every day definitely qualifies."
Evyn also describes the feelings of guilt that plagued her. "I thought I'd done something wrong to deserve diabetes. I was constantly searching and trying to understand why I was the only kid in my grade with diabetes."
Adolescence brings a new set of challenges. Anne Chaffin, 44, who counsels parents of diabetic children, says that diabetic adolescents "go through times where they want to forget about it. They pretend like they don't have it. After a while, though, they realize they're not hurting anyone but (themselves). It's all part of the process."
Evyn fell prey to these difficulties herself. "Whenever I had a bad blood sugar reading I would lie about it and say a different number, until eventually I was caught," she says.
Evyn, who is preparing for college next year, says her perspective has changed and that she plans to stay healthy and on top of her condition. "I have grown to appreciate my body and my life, because compared to some other diseases I really don't have it that bad." E-mail to a friend
LifeWire provides original and syndicated lifestyle content to Web publishers. Heather M. Ross, MS, APRN, NP, is an adult nurse practitioner specializing in cardiovascular care.
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