Each day, Maddie and Ashley McFeeley wake up, get dressed, inject themselves with insulin, eat breakfast, check their blood sugar and head to school.

Since they were toddlers, the twins have learned to live with Type 1 diabetes. Ashley developed diabetes first, when she was 1 1/2, and because the two are identical twins, doctors closely monitored Maddie, who became diabetic at 2 1/2. Ashley described Type 1 diabetes as when "your pancreas doesn't produce the insulin that you need. It doesn't disintegrate the sugars as well as it would if you had the insulin."

Now 15 and sophomores at Providence Day, the girls help others with the disease in a variety of ways.

The sisters, along with older sister Amanda McFeeley, a junior at Providence Day, and their family, have raised more than $57,000 to help fight diabetes in children. They host fundraising events for the Juvenile Diabetes Research Foundation and do the annual JDRF Walk to Cure Diabetes every year. (Bad weather canceled this year's April walk, but the girls still collected a donation, Amanda said.) Aside from organizing a walk team each year, the girls also raise awareness about diabetes by participating in advocacy videos used for the JDRF gala in November.

"As the years go on, our friends and family are used to the walk and say, 'Oh, I should donate,' or 'Oh, I should help,' " Amanda said. "We gain more and more people that are helping out."

The sisters have contributed to JDRF for the past 13 years. Laura Maciag, executive director of the JDRF Charlotte Chapter said the girls do so "by demonstrating that while diabetes is a challenging disease - it never takes a break, a holiday or vacation - yet they still do amazing things.

"They are successful students and athletes and find time to do all the things teenagers do, and they do it in spite of having diabetes."

During the year, all three sisters also contribute as mentors, visiting newly diagnosed families in the hospital, and as youth ambassadors who serve as greeters for JDRF events.

The sisters traveled to Washington in 2003 to attend JDRF's Children's Congress, and they advocate locally by meeting with congressional representatives, Maciag said. Their parents also are heavily involved, with father Patrick a member of the JDRF board of directors and mother Shauna on the executive committee of the Charlotte Chapter. The family will be recognized at a JDRF gala Nov. 5 for their efforts in supporting the foundation.

"The most rewarding part is seeing them make an effort to help others," said Patrick McFeeley. "I think they see that when they help JDRF they are helping millions of other adults and children living with Type 1 and Type 2 diabetes."

While their daily routines are more extensive than the typical teenager's, Ashley and Maddie say it is normal for them: They know nothing else.

"It definitely gets a lot easier," Ashley said. "In the beginning, your parents are going to be really strict about what you can eat. You can still eat sugary things every once in a while, you just have to make sure you take your insulin for it."

What happens when their blood sugar isn't right? They get stomachaches, or feel shaky when the level is too low, and thirsty when it's too high. Maddie said she even loses her sense of smell when her blood sugar is high.

"I asked the nurses about it and they said it was my body telling me to not eat sugary foods," Maddie said.

She advises kids with diabetes to "stay on top of it. It doesn't feel good to be high or low."

When Ashley was 4, Patrick McFeeley said, she had a seizure because her blood sugar dropped too low.

Now, Shauna McFeeley sends the twins a text every night that reads "TNT" - a reminder to test and text their blood sugar numbers to her. And Patrick and Shauna McFeeley get up several times each night to check their daughters' blood sugar.

"Ever since (the seizure) we have been checking in the middle of the nights," Patrick said. "Managing diabetes is like walking a tightrope. If you allow sugars to run too high over time, it can lead to long-term complications."

"For Ashley and Maddie, their health and diabetes management must be Priority No. 1," Patrick said. "If they take care of their health, diabetes should never keep them from doing anything they desire."