Kimberly Shoe vividly remembers her first days dealing with diabetes.
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"My parents had to learn how to feed the insulin, and how to regulate my diet around the doses," she said. "I think I spent a week in the hospital learning everything."
In the 33 years since, Shoe, now an advanced nurse practitioner in endocrinology at Nemours duPont Hospital, says managing the condition has changed a lot.
Now, instead of tailoring the food to the insulin, the emphasis is on healthy eating, then dosing insulin to meet that.
Technology is driving the biggest changes, especially since Shoe was a child.
"There was an insulin pump out but it was so big that it was probably heavier than I," she said.
Today, her insulin pump and its infusion line are barely visible above her waistband.
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She also wears a continuous glucose monitor to track her blood sugar around-the-clock.
"Five seconds, or every five minutes on your phone, you get an update," she said.
Her smartwatch also displays blood sugar readings, telling her whether she needs to eat something, or adjust her insulin.
Shoe's smartphone also shows the changes in blood sugar through the day. She's not the only one seeing them, either.
"My husband can see my blood sugar on his phone, just like parents can see their child's blood sugar when they're at school or at church or at, you know, athletics after school," she said.
Shoe doesn't just live with diabetes, she thrives.
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She's run 15 half-marathons and 18 full marathons, including the Boston marathon in 2008. It was only her second marathon.
The Diabetes Sports Foundation honored her as a " DSP Champion" last year.
She urges her patient families to use the technology, and work as a team.
"Diabetes is not going to overtake you, you can step into it and take control of it," she said.
Shoe says teamwork is also a must for Type 2 diabetes, and when families change their eating and exercise together, everyone in the family benefits.