It started with a simple case of the blahs. Twelve-year-old Jennifer Brown didn't feel like eating, she didn't feel like moving.

A week went by, and the Jackson Middle School student grew weaker and began to lose weight. When she started struggling to breathe, her parents took her to a local emergency room.

That was four months ago. Since then, Jennifer's life has become one long series of pricks and stings. She's all but given up candy and other sweets. Everything else in her diet has to be carefully planned to avoid too many carbohydrates.

And unless a cure is found for diabetes, that's likely how she'll live the rest of her life.

Jennifer is one of the 1,600-plus students in Missouri that the Department of Elementary and Secondary Education has identified as diabetic. Studies show that the number of children with type 1 and type 2 diabetes is increasing, and the impact of this disease on schools and society in general is growing as well.

Experts say the most troubling issue surrounding diabetes is that many people don't know they have it.

The American Diabetes Association estimates that 18.2 million Americans have diabetes, but that 5.2 million of them don't realize it.

The cause of diabetes is tied into how the body processes food. The body changes most food into a form of sugar, called glucose, which is then turned into energy by insulin, a hormone produced by the pancreas.

Diabetics can't produce insulin, causing sugar to build up in the blood and potentially damage internal organs, the nervous system and blood vessels.

Type 1 diabetes, once known as juvenile diabetes, is most common in children and young adults and is not preventable. Type 2 diabetes is connected to obesity and may occur more often in certain racial groups, such as blacks.

Because of her type 1 diabetes, Jennifer Brown injects herself with insulin five times a day -- before every meal, once in the afternoon and once at bedtime. She takes her blood sugar level by pricking her finger with a needle at least five times a day. At school, she stops by the nurse's office each day before lunch for her shot.

When her family eats out at a restaurant, she goes to the restroom for the injection.

"We can't go many places for very long without having insulin supplies," said her mother, Connie Brown. "We have to think more about what we're going to prepare for meals."

The hardest adjustment for Jennifer has been relinquishing sweets, especially when friends and teachers are constantly handing out candy and cookies.

"I don't think they do it on purpose, they just forget," she said.

Oct. 31 was a particularly difficult day this year, her first Halloween as a diabetic.

"I just tried to get away from the candy," she said.

Janet Stewart, a diabetic educator in Cape Girardeau, said there are a variety of challenges facing children with diabetes.

"One of the biggest things with kids is the fear of being labeled different or feeling they've done something wrong," Stewart said.

Stewart said diabetics also have to learn more about how the body works, nutrition and exercise than other children.

"One significant role we play is making sure they have a caregiver, a parent, feeling confident they can care for children," Stewart said.

Stewart said she too has seen an increase in diabetes in recent years, including a 10 percent growth in incidents of type 1.

That increase has prompted nurses in local schools to be trained in administering insulin shots. At Central Middle School, nurse Lisa Johnston currently works with two diabetic students.

"There's a lot of communication between parents and us," Johnston said. "We have to know their guidelines, when they need snacks. It's really a matter of guiding and supervising the kids."

While type 1 diabetes cannot be prevented, some local schools are also participating in special exercise and nutrition programs to address obesity and type 2 diabetes in children.

At West Lane Elementary in Jackson, nurse Kathleen Rice said students are involved in a program called "Jump Into Action," which is designed to help children make healthful food and activity choices.

"As a school nurse, I feel compelled to try to do something about it," Rice said. "Hopefully, we can reverse the cycle for future generations if we are diligent."

cclark@semissourian.com

335-6611, extension 128