Do you know what diabetes looks like?

It can look like your longtime neighbor across the street, your daughter's grade school classmate, even Grandma.

The face of diabetes is as normal as you and me, said J. Gary Evans, a local endocrinologist with Northeast Florida Endocrine and Diabetes Associates, and the disease has no economic prejudice.

With an estimated 23.6 million children and adults - about 7.8 percent of the U.S. population - diagnosed with diabetes, it's likely you know someone with the debilitating disease.

Diabetes is a metabolic disorder caused when the body is unable to properly produce insulin, a hormone naturally produced by the pancreas and needed to convert sugars, starches and other food into energy and fuel for our bodies.

It works like this: After food is digested, the pancreas produces the right amount of insulin to move glucose or sugar from blood into our cells. For those with diabetes, the pancreas produces too little or no insulin at all, which leads to a buildup of glucose, which is eventually passed out of the body through urine, and thus depleting the body's main source of energy.

Most diabetics are categorized into two main types: Type 1 and Type 2. Generally, Type 1 diabetics must take insulin daily and prick their fingers several times a day to monitor their blood sugar levels. In contrast, not all Type 2 diabetics have to take insulin. Their body just doesn't make enough or is unable to recognize insulin and use it properly. Still, they must monitor their blood glucose levels throughout the day.

Both types must take costly medications, use certain medical supplies/devices and have regular checkups with their endocrinologist to ensure their body is making and maintaining enough insulin for optimum health.

Costly? Perhaps. But, can you put a price on your health?

While some say the cost of living with diabetes is becoming more burdensome every day, they know the consequences of not dealing with the disease are far worse.

According the local American Diabetes Association office, the national call center received 4,681 contacts (both phone calls and e-mails) from those seeking aid with managing their diabetes during the last quarter of 2008. So far this year, more than 5,230 contacts have been received.

"One of the main goals of the American Diabetes Association is to help improve the lives of all people affected by diabetes," said Elizabeth Ingram, associate manager for Communications and Special Events for the local ADA office. "We have various informational and educational programs and services that allow us to help people manage their diabetes."

One of those seeking assistance from the ADA was 19-year-old St. Augustine resident Roxy Chapman, who also interns at the local ADA office.

Twelve years ago, Chapman was diagnosed with Type 1 diabetes, subsequently, she must take insulin daily and checks her blood sugar levels several times throughout the day.

Until Chapman turned 19 in January, she was considered a dependent under her mother's insurance plan. Now a full-time college student who cannot afford private insurance, she has enrolled in a plan offered by St. Johns County Public Health Department's Health and Human Services Primary Care Clinic.

"While I'm grateful to have some assistance, it's just not the same," said Chapman of her new health insurance policy. "When I was under my mother's insurance plan, I was able to get an insulin pump and a better glucose monitoring device. But this new policy won't pay for a pump, so I have to give myself [insulin] injections. Also, the new glucose monitor that I have now doesn't seem to be as accurate. It's a hassle, but it's what I have to do for now."

William A. White, 63, was diagnosed with Type 2 diabetes more than 20 years ago. He takes insulin daily and checks his blood glucose at least once a day, especially if he's not feing well.

White said he's fortunate to work for a company that provides its employees with a good health insurance plan and low co-pays.

But he is planning to retire approximately a year from now, and is concerned about how he will manage to pay for his medications and supplies once he's off his employer's health plan.

"If I keep the same coverage after I retire, the rates go up dramatically," said White. "So I'm shopping around now for rates to tie me over until I turn 65 and can go on Medicare."

So far, White said he hasn't felt the effects of the economy when it comes to his needed supplies and medications even though his co-pay went up. He still keeps his appointments with his endocrinologist, Evans, and goes for his lab work, too.

While Williams said he knows the year after retirement and before he turns 65 will be difficult financially, he hopes that he has Evans on his team.

"Communicate with me," said Evans. "It's what I ask of all my patients. When we know what's going on in our patients' lives and how that can affect their health, we can help."

Williams said Evans offered to help him through his transitional year by providing samples and resources for organizations willing to be more financially cooperative.

Still, Williams said he knows that caring for his health is up to him. One way he tries to keep his health care costs down is to manage his diabetes with care.

"I don't smoke or drink and I have to credit my wife for cooking healthy meals," said White. "I believe that makes a difference in keeping me healthy and my health care costs down."

Evans agreed. "White is an ideal patient who understands what it takes to live with diabetes," said Evans. "He's aware that it's up to him to stay healthy financially and physically.",(904) 359-4058