Living with diabetes is a challenge, especially for kids and their parents. But thanks to the holistic approach of the team of educators, social workers, nutritionists and doctors at Lucile Packard Specialty Clinic, families can learn to cope with the disease while living life to its fullest.

"As a person with diabetes, there is nothing you can't do," says Betsy Bluck, a registered nurse and a certified diabetes educator. "It's never a no-brainer -- every activity requires you to consider your diabetes." But diabetes isn't an excuse to stay on the sidelines, she adds.

Bluck speaks from experience. She's a runner, a mountain biker, a scuba diver, and she has diabetes.

A growing problem

The kids seen at the clinic have juvenile diabetes, also known as Type-I diabetes. Juvenile diabetes leads to a lack of the insulin needed to convert blood sugar into energy. Children with diabetes can't leave home or even start their day without a blood sugar test and insulin. They typically have to keep track of every piece of fruit or slice of bread they eat.

"But at the diabetes clinic, the kids aren't sick," Bluck says, adding, "so we never treat them like they are." More importantly, the clinic staff teaches them how to stay healthy.

Today almost 15,000 American children are diagnosed with juvenile diabetes each year, according to the Juvenile Diabetes Research Foundation. The cause of diabetes remains a mystery. Siblings of children with diabetes have a greater chance of having the disease, but genetics is not the only factor. Some scientists think a virus lurks behind the disease.

"More kids than ever are being diagnosed with diabetes at younger and younger ages, and no one really knows why," she notes.

Learning healthy living

Diabetes has no cure, but it can be managed with daily insulin injections or a pump that delivers insulin to the body continuously. More families are choosing pumps to manage their children's diabetes, Bluck says. She herself has used a pump for 15 years.

"It's the most progressive and aggressive treatment, and allows for the most flexibility," she says. "With the pump, there are more decisions to make, but you don't have to live your life like a diabetic. I like to teach kids how to adjust insulin for whatever it is they want to do."

Bluck spends hours training kids and their parents to use the pump effectively. Too much insulin and blood sugar can drop too low; too little and it can shoot up rapidly. Each person's insulin needs are unique: "It's an experiment of one," she explains.

Patients start with an estimated insulin requirement based on age and weight. From there, they learn through trial and error how much baseline insulin their body needs and how much additional insulin is required to cover for the foods they eat. The body also reacts differently to sugar and insulin depending upon activity level and excitement. Fine-tuning takes time and patience, not to mention lots of advice from the educators.

Bluck's involvement doesn't stop there, however. Families continue to get support from her and her co-workers during regular visits to the clinic, and she's "the voice at the other end of the line" any time a concern arises.

A defining inspiration

Bluck wants her patients to realize as she did that the sky's the limit. Her personal turning point came when she wanted to ride cross-country on a bike trip. Her doctor at the time told her it couldn't be done. Dissatisfied, she found another doctor who helped her prepare. "It was very empowering," she says. Her goal ever since has been to empower others the same way.

Parents need to be reminded that diabetes doesn't come with inherent limitations, she says. She remembers one family that was shocked when they learned that Bluck races mountain bikes. They had assumed their child, diagnosed with diabetes at age 3, would never be able to meet such challenges.

While she's a source of inspiration at the clinic, she couldn't do it alone. She has the benefit of a team, each with his or her own strengths. Allie Flanders, MSW, a social worker, helps families with the emotional and social aspects of diabetes, says she, "relies on Betsy to understand the nuts and bolts of the disease."

The bottom line for all at the clinic: providing tools and information to help families gain control over diabetes, opening a lifetime of good health.