Riding a mountain bike from Jerusalem to Eilat in five days would be a major challenge for any teenager, but Nadav Ostrin, a 16-year-old Jerusalemite diagnosed with Type 1 diabetes four years ago, has accomplished this with no special difficulty. In fact, participating in Alyn Hospital's fundraising marathon was not new to him: He completed the somewhat easier 500-kilometer route between the Golan Heights and Jerusalem last year. "I was the only diabetic, but the oldest person on the ride was an 81-year-old, and as far as I know, he did fine," Nadav said in an interview soon after returning to his home in the capital's Baka quarter. His parents, Asher of the Joint Distribution Committee's (JDC) Israel office and Ruth of the Rothschild Foundation, were not very worried, as he had already proved his ability to ride long distances last year. But this time, he did not have to inject himself manually with insulin; he received an insulin pump two weeks ago. He still had to test his blood sugar levels four or five times a day, but he could eat anything he wanted. Because of the physical exertion involved, he programmed the pump to inject only half the amount of insulin he usually does. He also took with him sweet "power bars" for eating if he felt any low bouts of sugar coming on. Nadav, an 11th grader at the Ohr Torah yeshiva high school in Efrat, singlehandedly raised $3,000 for Alyn, Jerusalem's national rehabilitation center for physically disabled children and teenagers. The sponsorship money was donated by relatives, friends and acquaintances. On the marathon, there was a tough leg at Ma'aleh Ha'akrabim (Scorpions' Ascent) on the way to Eilat, but Nadav said he had no flat tires and no mishaps. Every few kilometers was a "pit stop" for all 475 riders, who were given water and a snack. He had no real muscle pains after the marathon as he had trained with a friend to prepare for the exhausting ride. Diabetes came as a complete surprise to him and his parents because there was no previous case in the family. His 21-year-old brother and Nadav's twin sister are both healthy. "Nadav caught a virus and suddenly, he suffered the symptoms of extreme thirst and urination," Ruth recalled. "He went into the doctor's office a healthy kid and was out with two shopping bags full of insulin, needles and a glucometer. It was completely shocking." His physician, Dr. Harry Hirsch, said the virus apparently triggered an autoimmune response that killed all the beta cells in his pancreas. "Dr. Hirsch is very positive and wonderful with kids," Ruth continued. "He insists that young diabetics be responsible for taking care of themselves. It took Nadav a while to realize that if he didn't take care of himself, he would feel terrible and be very sick. Now it is a routine for him." "I didn't really know what it was," said Nadav. "I freaked out, but then you start living with it." His teachers, he said, "are great, and my classmates understand, even though I am the only diabetic in school. During the first year, I had to explain. I do sports, especially swimming, regularly." He added that he is not angry that diabetes happened to him. "I keep my sugar under control, and I can eat everything. It doesn't bother me doing the blood sugar tests; it's routine, like brushing my teeth." But he still hopes for an eventual cure. Ruth, who came on aliya with her American family in 1992 after her husband worked for six years for the JDC in Vienna and London, said the only sour note in Nadav's treatment was from Kupat Holim Meuhedet, their health fund. "They have been stingy," she said, "giving the barest minimum of equipment he needs and refusing to give him the type of insulin his doctor prescribed. The health fund apparently does not trust its doctors, who know what is best for their patients."