"Why me?" Miriam Cantu asked when the doctor relayed the news that she had diabetes and would have to check her blood sugar twice a day for the rest of her life.
"Poking needles into myself is no way to live."
Miriam is 12 years old. Her mother, Oralia Cantu, 50, has lived with the disease for nearly three decades.
Mother and daughter are a microcosm of a health problem in this largely Hispanic border town of 13,000 people -- and among the Latino population in general.
Half the boys and more than a third of the girls in Rio Grande City are overweight by the time they reach the seventh grade.
And increasing numbers are developing diabetes and its deadly complications, health officials say.
"Stand on any street corner in Rio Grande City," said Enrique Griego, a doctor who operates three clinics on the border. "One of every three people you see is overweight or obese. To me, they are future diabetics."
What is emerging is a health calamity that will probably cost Texas billions of dollars, said Eduardo Sanchez, commissioner of the Texas Department of State Health Services.
"Obesity is on the rise, and more children are being diagnosed with diabetes," Sanchez said in an interview. "This isn't something we should ignore."
The Texas Diabetes Council says the lifetime medical bills of young diabetes patients could cost Texas $15 billion by 2025, bankrupting families and threatening to cripple government health agencies. In 2002, the costs nationwide of treating diabetes reached $132 billion.
"The problem is getting worse," Griego said. "We are identifying more and more people who have diabetes at an early age."
Of greatest concern, he said, is Type 2 diabetes, which until recently was found mostly in overweight adults 45 and older.
Griego is seeing it in children as young as 6.
"When you get the disease early in life, it is very aggressive," he said. "It has terrible complications: heart attack, stroke, blindness, amputations, kidney failure. But people don't always take it seriously because it doesn't hurt. It takes a while to kill you."
Today's high-fat, high-sugar diets -- along with genetics and a sedentary lifestyle -- are the main risk factors for Type 2 diabetes, according to the Texas Diabetes Council.
Diabetes sufferers along the border are largely Mexican American. Many have a history of the disease in their families.
Cantu is worried about her daughter.
"Diabetes affects my entire body. I'm almost blind," she said. "They've had to operate on my heart, and soon I'll be going on dialysis. Now my daughter faces the same thing."
Minorities have a greater risk of developing Type 2 diabetes than whites, and residents in poverty-stricken border towns face the greatest peril, health officials say.
Unhealthful food is cheap and readily available, said Maria Olivia Garza, a Rio Grande Valley nurse.
Garza teaches health classes for overweight children and their parents here, which experts describe as ground zero for childhood obesity and Type 2 diabetes in Texas.
And while she has seen progress, she said it is difficult to get children to watch what they eat.
"Immigrant families want to give their kids a better life," she said. "And what do the children want? They want pizzas, hamburgers and sodas. They don't understand the consequences."
Cultural traits add to the difficulty, said Hilda Guerra, manager of Starr County Health Studies, which does diabetes screening here.
"Our parents believed that a fat child was a healthy child," she said. "At an early age, children learn that if they make good grades, we're going to take them to Pizza Hut. We're always praising children with a meal or a cake."
Sanchez predicts that half of the Hispanics born since 2000 will develop Type 2 diabetes unless they take precautions.