Sarah Coffey of Peoria, Ill., is a typical 14-year-old. She goes to school, plays in her school's band and enjoys hanging out with her friends.
But what sets her apart from most other girls her age is that she has Type 1 diabetes.
What sets her apart even more is that her two younger siblings also have the disease known alternately as juvenile diabetes.
Doctors diagnosed Sarah three years ago. She was the last of the three children to get the news.
"Sarah's diagnosis was the hardest to deal with, because it seemed so unlikely that it could happen," said Lori Coffey, Sarah's mother.
That all the Coffey children have diabetes while their parents don't is indeed an anomaly.
"Five percent of the families we see have more than one child with diabetes. It's very unusual to get three," said Dr. Bruce Buckingham, professor of pediatric endocrinology at Lucile Packard Children's Hospital at Stanford in Palo Alto, Calif.
He has no affiliation with the Coffey family.
Emily Coffey, the middle child, now 11, was the first to be diagnosed with diabetes. She was two and a half years old at the time.
"She was still in diapers, and I noticed that her diapers were really, really full," Lori Coffey said. "That indicated to me that she was urinating more and I knew that was a symptom for Type 1 diabetes."
The heavy urination continued so Coffey and husband Brian brought Emily to the doctor.
"They checked her urine for glucose and that test was positive, and then they checked her blood-sugar and the level was so high that the meter couldn't even read it," she said.
A few years later, Coffey got the same diagnosis for 5-year-old Matthew Coffey.
"One morning, he had wet his bed," she said. "He had been drinking a lot of water, and I checked his blood-sugar and it wasn't terribly high, but I knew it was too high for someone with a healthy pancreas.
"We took him for some outpatient treatment that day and the doctor started him on insulin that day."
Six months later, Sarah found out she also has Type 1 diabetes.
"I was really sad and mad and disappointed," she said.
But once the initial emotions wore off, she said, she was able to deal with the condition that has affected most of her family.
"It wasn't too hard, since my brother and sister already had it and I already knew about it," she said.
For her, the hardest part is worrying that her friends will find out.
"When I'm out, people don't know I have it and I have to tell them," she said. "I have to check my blood sugar and bolus [insulin] in front of them and it's hard to explain."
"Standard protocol is to check their blood sugar levels 8 to 10 times every day and count the grams of carbohydrates they eat, so we're constantly looking at labels," Coffey said.
The children all use insulin pumps, which are attached all the time by a catheter that goes under the skin. Their sites need to be changed every two to three days.
With insulin pumps, Coffey can input the children's blood sugar and the number of grams of carbs they've just eaten. The pump will then dispense the appropriate amount of insulin.