For many Americans, diabetes is considered the result of age or an unhealthy diet. It means cutting back on sugars, getting more exercise and possibly taking a pill, but the true story of diabetes is not so simple.

In reality, diabetes comes in two very different types. The more common form is Type 2, which is a metabolic disorder in which the body either produces or underproduces insulin and does not properly use it. In these cases, it is not the pancreas that is not working, it is the cells in the body that are supposed to use the insulin to break down carbohydrates and turn them into useable fuel for the functions of the body.

Patients with Type 2 can help control their symptoms with diet and exercise. Sometimes, a pill is taken to help the body use its own insulin.

This form is both genetic and environmental. Families in which there are a number of cases of Type 2 diabetes show an increased chance for other family members to follow suit. The form is also a measure of environment and diet. High body weight and unbalanced diets can create insulin resistance within the body.

On the other hand, Type 1 diabetes is an autoimmune disorder. At some point in a person’s life, usually at or before adolescence, the body’s immune system begins to attack the part of the pancreas that produces insulin. There is nothing to be done to stop it once it has begun or to prevent it before it starts, and it will lead to a person producing none of their own insulin. It is not caused by genetics, poor diet or environment.

Because it only makes up 5 percent of the approximately 16 million cases of diabetes in the United States, it is often misunderstood. Children who develop Type 1 cannot store glucose, allowing it to build up in the blood stream causing excess urination, dehydration and other serious results. Because the body cannot break down carbohydrates into fuel, it begins to work at breaking down fat, which produces a poisonous byproduct that can cause death.

An unmanaged Type 2 diabetic can also see these ill effects of the body failing to break down glucose. The two types are strongly linked in this way and by the careful balance required by the disease. Type 2 cases vary greatly in their severity, but people who live with the disease must be aware of the carbohydrates they consume, the exercise they get, the medicines they take and the effects of each of these on their blood sugar. Type 2 cases may be able to be resolved by weight loss and a carefully controlled diet. Type 1 cases will never be resolved until a cure is found.

For a Type 1 diabetic, life becomes a constant balancing act. Insulin must be given in response to the foods the person eats. The patient, or their parents, must think like the pancreas should, providing insulin to balance the carbohydrates consumed. While insulin pumps and injections might not seem to go alongside tubes of icing or pieces of candy, the balance can also quickly shift in the other direction. If the person has administered too much insulin for the carbohydrates eaten, the blood sugar can become too low. This, too must be remedied.

For some children, the process of controlling the balance between carbohydrates and insulin begins as early as two weeks into their young lives. It requires pricked fingers to determine blood sugar, injections with every meal and constant vigilance on the part of the parent or guardian. Insulin pumps can improve the feeling of normalcy a family has by allowing a few punches of a button to do the difficult work of administering insulin to the body, a far cry from syringes and injected medications carefully measured every time a child eats. It is difficult to control one’s worries, parent Wendy Bohman noted. Things that could be just a bad mood in the average child can be a cause for alarm in a child with Type 1 diabetes. Blood sugar tests are frequent and every food label must be studied to ensure an adequate insulin response.

In order to offer support to parents whose children live with diabetes, Bohman and fellow parent Candy Wesseler began a Children with Diabetes Support Group. The sessions are held at 6:30 p.m. on the last Tuesday of every other month at Decatur County Memorial Hospital. These meetings are intended to give parents a place to discuss concerns, celebrations and shared experience in an informal yet educational environment.

The next meeting will take place at 6:30 p.m. on September 30.

This article includes information from the Everything Parent’s Guide to Children with Juvenile Diabetes by Moira McCarthy with techical review by Jake Kushner, M.D.