of at least twice daily insulin injections, urine testing four times daily (later daily blood testing),regular visits to the doctor, and frequent visits to the hospital.We also were introduced to a new way of eating that involved calculating the ³TotalAvailable Glucose´ (³TAG´) in his daily diet (a part of therapy his next pediatriciandiscontinued), and limiting refined sugar as much as possible. We were told to keep his sugarslow enough to test out as ³trace´. This way, we would be sure that Steve¶s blood sugar levelwasn¶t too high to be unhealthy (though ³unhealthy´ was never defined for me), or too low tocause insulin shock (convulsions and coma).These seemed like simple guidelines, but we soon learned that Steve was a ³BrittleDiabetic´ a condition that affects about three in every 1,000 juvenile diabetics. Even though wefollowed the rules regarding insulin dosage, exercise and diet, Steve often experienced wild anduncontrollable fluctuations in his blood sugar levels. If a late morning urine test showed a high³spill´ of sugar into his urine, for example, he would need an extra shot of insulin. Some days, asmany as 10 units of the fast-acting regular insulin would be needed but other days 2 units woulddo the job too well, sending him into insulin shock. This meant that Steve would sometimes haveto endure an injection of 1 or 2 units every half hour until his blood sugar returned to a morenormal level.Aside from close monitoring, daily life for a child living with Juvenile Diabetes canclosely resemble the daily life any other child. There are no outward signs of the inner diseaseprocess, except when his blood sugar plummeted, depriving his brain of the fuel it needed tofunction. At these times, he would become lethargic, sweaty, and get a wild, unearthly look inhis eyes. He would behave irrationally, and if his glucose level wasn¶t raised soon enough, byforcing him to drink orange juice or prying his mouth open to pour in spoonfuls of sugar, hecould go into convulsions, and eventually a coma. Even on those days when Steve¶s blood sugarswere very high, he looked like just another normal, healthy boy.But on the inside, those high blood sugars were causing irreparable damage to his internalorgans. We had no idea that, little by little, it was killing him because we couldn¶t keep hissugars within normal limits. After 25 years of living with diabetes, it became obvious that the years of uncontrollablehigh blood sugars were taking their toll. In the years leading up to his death, Steve developed andfought many of the complications of diabetes: Any scratch or flea bite, especially on his arms,could easily develop a staph infection. His skin was often painfully itchy. In his early 20s, hedeveloped dental disease. At 27, he was diagnosed with diabetic retinopathy. He would havebeen blind the rest of his life had a kind eye surgeon not donated his services. The doctor removed the blood-clouded fluid from his eyes, repaired the retinal tear, and then refilled hiseyes with a substitute clear fluid as Steve reclined in the chair perfectly still, yet wide awake.When he was 28, his kidneys failed, necessitating first hem-, then peritoneal dialysis. Theperiodontal disease was one of the things that made him ineligible for a kidney transplant.(Among the other factors were his ongoing troubles controlling his blood sugar, adhering to thevery strict kidney failure diet, and smoking cigarettes.) The kidney failure caused half dollar-sized grainy skin ulcers (caused by calcium deposits in his skin) all over Steve¶s body, includinghis head and handsome face. At 30, he developed neuropathy (nerve damage) in his feet, causinghim to develop a ³slap foot´ gait; every step was like walking barefoot on cactus. Also at 30, hehad a mild heart attack. A few months before he turned 31, his energy level plummeted.