Richie Southard is a blond headed ball of energy who loves trains and superheroes. In almost every way the boy preparing for his 2nd birthday Friday is an average rambunctious, curious child.

But that breath of life and spark of curiosity are thanks to a marvel of modern medicine. A year ago, Richie was stretched on a gurney on the verge of slipping away into a coma.

Just after his first birthday, Richie was diagnosed with Type 1 diabetes — a rare autoimmune disorder that prevents his tiny pancreas from producing insulin. Less than 1 percent of Type 1 — also called juvenile diabetes — patients are younger than 5.

The disorder, as of yet, has no cure.

“You don’t want to say it’s a life and death thing, but it is,” his mother Erin Southard said.

In 2014, the Southard family was at the circus when Richie began vomiting uncontrollably. Earlier in the day he had been urinating frequently to the point that his diaper was overflowing.

His father, Ritch Southard, said they thought Richie must have had some sort of virus.

“Erin and I talked about what to do — should we call the doctor or just go to the ER. After a short debate we decided to go to the ER,” Ritch said.

When Richie arrived at the emergency room his blood sugar level was 600. A blood sugar content of 130 to 180 is considered high, and 600 is the point at which most patients slip into a coma.

The family was wrought with worry.

“I said to myself look at my kid. Here’s a 12-month-old laying on a gurney not moving or interested in anything,” Erin said.

Since beginning insulin injections, Richie has dramatically improved to become the average toddler he is today. Yet, it’s a 24-hour a day struggle. His parents have to constantly monitor Richie’s sugar and closely watch what he eats.

“It’s exhausting. It’s tiring, but it’s your kid, so you do what you’ve got to do. He’s a happy baby. He doesn’t know,” Erin said.

The family began by giving him shots, but in September they switched to an insulin pump about the size of an old wireless pager. He wears the life-saving apparatus in a small light green zippered pouch on his side.

The Southards have the pump wirelessly connected to a flat screen display monitor that allows them to constantly keep tabs on Richie’s sugar. It gives real-time updates on his blood sugar and the amount of insulin in his pump.

“We still have to finger prick, but at night and during the day, we can watch on here and monitor what’s going on with the pump,” Ritch said.

Such technology is just the latest in the quick moving world of Type 1 diabetes research.

“There’s so much out there that it gives you hope that in his lifetime, he won’t have to have an apparatus attached to his body and prick his finger 10 times a day,” Erin said.

That hope led the Southards to recently film a promotional video for the Juvenile Diabetes Research Foundation.

“He’s going to get to be a normal kid. We’ve found out that the only things he can’t do are become an astronaut or join the military. And no commercial pilot’s license,” Erin said.

Juvenile diabetes research has moved at an almost astronomical pace, considering the mortality rate it had a few generations ago.

Before Canadian medical researchers gave the first insulin injection to 14-year-old Leonard Thompson in 1922, Type 1 diabetes was a certain death sentence. Before insulin therapy, diabetics had little chance of living for more than 20 months after diagnosis. Fewer than 10 percent lived for five years.

“It was universally fatal, until insulin was discovered. It’s basically an absolute lack of insulin,” said Dr. Deborah Smith, a longtime pediatrician with River Region Medical Center.

Now, Type 1 diabetics are living longer than ever before to an average age of 73 for women and 69 for men, according to a study published in January in the Journal of American Medicine.

Smith credits the longer life span to diabetics being able to maintain tighter control over their blood sugar levels thanks to advents in technology like that used by the Southards.

“The pumps have increased efficient and delivery systems, and we’ve got a number of different types of insulin depending on your activity level and your body’s sensitivity to the insulin,” she said. “As of yet, we don’t have a total cure. There are some good studies and treatments where they are trying to transplant cells to try to produce insulin.”

Yet diabetic complications still persist, and in the past 20 years, more children than ever have been diagnosed with Type 1 in the developed world, according to a study from the German-based Diabetes Research Institute.

No one is sure exactly what causes Type 1 diabetes, but the answer could lie in the human genome.

“There’s a defiantly genetic component to Type 1,” Smith said.

Richie’s grandmother has Type 1 diabetes, which could have predisposed him to the disorder. However, the risk is much greater yet still slim for patients who have a parent or sibling with Type 1. That risk is about 10 to 13 percent, according to the German study.

Often a Type 1 diagnosis is preceded by a viral infection, which scientific research suggests could release antibodies that attack the pancreas and prevent the production of naturally occurring insulin.

Type 1 diabetes remains rare, despite its increased prevalence. The major increased danger for children is Type 2 diabetes, which is caused by obesity and unhealthy eating habits, Smith said.

“I would say I have maybe 20 times more Type 2 patients. We have such obesity in the school age and teenage population that we are seeing many more Type 2 diabetics or impending Type 2,” she said. “It is probably the first 20 years I was in practice I could count on one hand the number of Type 2 diabetics and now I see multiple new Type 2 diabetics every year,” Smith said.

Long-term health risks from both types of diabetes include high blood pressure and an increase in cardiovascular and kidney diseases, Smith said. Type 1 diabetics also suffer a higher instance of thyroid problems.