Ethan Phillips has had type 1 diabetes since he was five, in other words, as long as he can remember.  He is used to living with the disease and has accepted the challenges he will face for the rest of this life, but there are still some thing he doesn't like doing.

"I've gotten used to poking my finger" said Ethan "but shots still hurt"

His parents, Doug and Deanna Phillips, continue to help him everyday with a disease that will always be a part of their son's life.  Deanna recalls additional hardships they encountered with their son because for a long time he didn't understand that he couldn't always do the same things as other children.   She recalls one time during a first grade school party where Ethan wanted to have a cupcake, but could not because he already had his snack for the day and wasn't allowed to eat any more at the time.

"I don't think people realize, you know first of all, we have to worry about everything he eats, and how many times a day he checks his blood, and how many shots a day he has." said Deanne "I mean when you think of your body being a pin cushion, it really is and I think a lot of people think, don't realize that that's what's going on."

Scientists do not know what causes type 1 diabetes.  They know that the bodies own immune system attacks the insulin-producing cells in the pancreas which causes the body to stop producing insulin.  Doctor David Goldstein is the leading pediatric endocrinologist at the University of Missouri Children's Hospital.  He says type 1 diabetes is a genetic disorder that usually presents during childhood and patients are fully insulin dependent.  This is different than type 2 diabetes which occurs when the body becomes resistant to insulin, but the body doesn't completely stop producing insulin.

"The type 1 diabetes that causes destruction of the little cells in the pancreas called beta-cells that make insulin. It's inherited and it's great we have insulin now because before insulin, everybody died....type 1 is just different in that it usually presents during childhood."  said Goldstein.  "Children are generally not overweight, that's not part of the reason they get diabetes."

People with type 1 diabetes are completely dependant the insulin they must take four or five times a day in order to live.  Elizabeth McCollum is very aware of the strain this puts on living a normal life.

"I have to live with this for the rest of my life, I can't slack off...I have to do this, I have to eat during school, I have to take shots, you have to do this every single day." said McCollum.

Type 2 diabetes, on the other hand, has a very different treatment approach.  Doctors associate much of type 2 diabetes' treatment approach to weight.  If patients lose weight and start eating healthy, they can significantly reverse the effects of their disease. 

Many people are not aware of the acute differences between type 1 and type 2 diabetes.  The term "diabetes" has become synonymous with overweight and eating excessive sugars.  According to medical experts, the word diabetes is not an all encompassing term that includes all the different types of the disease.

Ken Luraas is the director of Columbia's Camp Hickory Hill, which is a camp that aims at both educating and entertaining children with type 1 diabetes.  The camp provides insulin therapy, diet and exercise management, and the reassurance they are not alone since all the other children around them are dealing with the same challenges.

"The greatest myth is well, if you just get the insulin right, then all your problems go away." said Luraas "It is a very demanding disease and it requires great effort to take care of yourself."

Many children need a team to help manage their disease which includes doctors, nurses, dieticians, and social workers.  The camp provides all of these to the children while they are staying at the camp during the summer.  Outside of camp, children need to visit their team three or four times a year to receive treatment for their diabetes.

According to Luraas, cost is another challenge for families with children who suffer with diabetes.  If a family does not have any medical insurance, the cost of diabetes can be as high as $900 a month.

"Many people cannot afford the medical expenses associated with diabetes" said Luraas. 

Those expenses include visits to the doctor, but also the needles, insulin, test strips, insulin tester, glucose supplements, and alcohol swabs.

According to Dr. Christopher Patterson, an epidemiologist, a recent trend in type 1 diabetes is shifting toward children at a younger age.  There has been a 3.9 percent increase in children developing the disease each year since 1989.  Researchers break down the research into age groups:  5.4 percent increase in children under five, 4.3 percent increase in children six to nine, and a 2.9 percent increase in children ten to fourteen.  Researchers say that is this increase continues, the number of children with diabetes will double by 20-20.  The research was done at Ireland's Queen's University, but research say the trend is also applicable to the United States.  Researches have concluded that there could be some kind of environmental factor causing the increase, but they do not know what it is.

Many children with diabetes feel uncertain about the future and have additional fears healthy people do not have to deal with.

"I might be alone and pass out or be unable to reach what I need to fix the problem if I have one." said Ethan Phillips.

Doctors day good management and a support system are key to successfully living with diabetes.