About 250,000 children in Germany have diabetes and concerns grow as three to four new children here are diagnosed with diabetes every day.
As incidence of the disease have increased, some families have turned to a private nanny service to help with the rigorous medical care, often including thousands of insulin injections throughout a patient's childhood.
The nannies' help is often the closest thing the diabetic children can get to family care, as the founder of the service and many of its volunteer nannies are parents of diabetic children.
The most common form of diabetes in children is type 1. About 90 percent to 95 percent of kids younger than 16 have type 1 diabetes, which is caused by the inability of the pancreas to produce insulin. The cause is not known, and the majority of kids don't have a family history of diabetes. There is no cure for this type of diabetes, which afflicts patients for the rest of their lives.
Type 2 diabetes has been seen for the first time in children and adolescents in recent years, and although the cause is also not known, experts are suggesting that it is probably connected to the increasing trend toward obesity in Western societies.
While German health professionals usually provide good medical care, it is not easy for parents to cope with their kids' disease in daily life.
Help and support, however, is just a phone call away.
Ingrid Pfaff is the president of a foundation called Dianino, a private family support network of volunteer "diabetes nannies."
Together with about 260 other volunteers, most of them women, she helps families in dealing with the disease.
"There's much more involved than just the medical aspect," she said. "The diagnosis that your child has diabetes mellitus, as it is called correctly, is frightening, overwhelming and scary for most parents."
"That's where we come in," Pfaff said. "Our nannies are well-trained. Most of them have some kind of professional medical background, and others have kids with diabetes to care for in their own family. The local pediatricians put us in touch with the families who need nanny help and our service is free of charge."
Pfaff, 45, brings a lot of firsthand experience to those families in need.
Her 24-year-old son was diagnosed with diabetes at age 7. "At the time it was a shock and I had to learn from scratch how to deal with the disease," she said.
A few years ago she came up with the idea to establish the diabetes nanny service.
"Living with diabetes can put families under considerable strain, so access to backup support is really crucial," she said. "Can you imagine what it's like to give your 3-year-old injections several times a day? It can be totally nerve wrecking and exhausting for both, the parents and the kids."
Pfaff says that a child who is diagnosed with diabetes at age 3 is likely to have had about 27,000 shots of insulin by his or her 16th birthday.
Christa Siegel, mother of four, has been a volunteer diabetes nanny for about 18 months. She has helped about 20 families over that period of time.
"We help them manage the disease, and we show them how to stay healthy and well. Sometimes it's just the little things that matter, like teaching the kids not to drink sugary soft drinks or that life is OK without sweets like gummy bears."