Aim: Bring end to Type 1 diabetes

A USF researcher gets $189-million in grants to try to find the causes of the disease.

By LISA GREENE, Times Staff Writer
Published November 17, 2007

TAMPA - The Swedish toddler and University of South Florida professor Jeffrey Krischer didn't speak the same language, but she still won his heart.

She waved and smiled when they met at her doctor's office in Sweden a few weeks ago. Krischer liked how she "didn't even wince" when a technician drew her blood.

They will probably never see each other again. But the U.S. government is giving $189-million to USF to make sure Krischer knows the tiniest details of her life.

As part of the biggest grant USF has ever received, Krischer and a team of researchers will track whether the little girl gets a stomach virus or chicken pox, eats broccoli or tomatoes, gets a pet rabbit or a puppy.

Most of all, he will see whether she is unlucky enough to get the dread disease she already is at high risk for: diabetes.

The National Institutes of Health awarded the grant to study what factors in our environment - food, illnesses, behavior - influence who gets Type 1 diabetes, a life-altering disease that is striking at twice the rate it did 20 years ago.

How did Krischer, an unassuming 60-year-old statistics expert who hates to talk about himself, haul in USF's biggest research prize?

In some ways, he was the right man at the right time.

Government officials wanted to know more about what causes diabetes. To find out, they needed someone who would know which questions to ask and how to analyze massive amounts of data. A top-notch statistician with a deep understanding of diabetes.

It was a job made for Krischer, who built a career applying his math skills to medicine, and picked up a fascination with diabetes while working at the University of Florida.

The Environmental Determinants of Type 1 Diabetes in Youth, or TEDDY study, is staggeringly ambitious: More than 250,000 newborns in six countries will be screened. About 8,000 babies, those found to be genetically at high risk, will be followed for 15 years.

Lives documented

The lives of those children will be exhaustively documented. Researchers will take blood from each child every three months. They also will work with parents to document the children's diets, illnesses, vaccinations and living conditions. Families will keep a "TEDDY book," to be updated every three months.

In pursuit of science, baby poop will be mailed around the world to be stored in a U.S. research lab.Researchers will even collect toenail clippings.

Over time, some of the babies will grow into children with a grim diagnosis. Krischer expects about 500 of them to develop Type 1 diabetes. Their bodies will stop producing insulin, the hormone that converts sugar to energy.

Type 1 diabetes can lead to a whole host of medical problems. Among them: heart disease, nerve damage, blindness and kidney failure. Even without complications, the disease requires constant vigilance. Patients must watch their diets and check their blood sugar often. They never get a day without thinking about their disease.

The need to know what causes diabetes has never been more urgent. Like its more common cousin, Type 2 diabetes, rates of Type 1 diabetes are skyrocketing. But the Type 2 surge is clearly linked to epidemic obesity rates.

The reason why the Type 1 diabetes rate has doubled since the 1980s is more mysterious. Is it linked to diet? Could it be a virus or some infection? Some kind of environmental pollutant?

If only researchers could figure out what triggers the disease, maybe they could prevent it, Krischer said.

"What would be great , as far as I'm concerned, is if this would be the last generation to know what diabetes was," he said.

That desire is what drove Krischer to pursue the grant making USF the coordinating center for the TEDDY study. Researchers here will collect data from six different clinical centers. The closest is in Gainesville; others are in Finland, Sweden and Germany.

At USF, 60 computer servers track all this information. The storage space of the computers is roughly the space of 800 home PCs. Researchers also use the Web to share information with each clinical site.

His other work

TEDDY isn't the only study Krischer is working on. His other work includes a study to test whether changing baby formulas can help prevent diabetes in high-risk children.

Growing up in Miami, Krischer became interested in medicine. His father had stressed the need to make a difference in the world.

"I believe you should do things with your life that are worth the time you spend on them," Krischer said.

Krischer studied in Chicago, then at Harvard. After joining the faculty at the University of Florida, he found colleagues working on diabetes and joined them. He came to USF in 1993.

Krischer's background was the perfect fit when the NIH decided it needed a long-term study on the causes of diabetes. In some cases, researchers decide what they would like to study and ask the NIH for funds. This time, the NIH set the agenda and asked for applicants.

Krischer's proposal beat out several others to win the first $20-million grant to start TEDDY last year. The NIH opened the field up again before awarding USF a second grant for $169-million, which will fund the work for the next 10 years, said Beena Akolkar, director of an NIH program on Type 1 diabetes.

"Dr. Krischer is an expert in the field," she said. "He's not only a good statistician, but he also has experience with Type 1 diabetes."

Krischer's work on the grant thus far has been "fantastic," Akolkar said. The grant is on track with its goals, she said. Halfway through the period for enrolling patients, about 3,900 families have signed up.

Krischer's quiet devotion to the cause has won the admiration of his dean, Dr. Stephen Klasko, vice president of USF Health.

The next goal

"One of the things I have come to really respect about Jeff is he's not going to be out there marketing himself," Klasko said. "But he is literally obsessed with coming up with answers. ... His entire focus and energy has been on solving these very difficult health care dilemmas."

Klasko's next goal is to make USF a "powerhouse" in medical statistical research. He wants to provide Krischer with the resources to expand his work into other strong areas for USF research.

Krischer is ready to tackle such challenges. His research already includes work on other autoimmune diseases.

But right now, his chief focus is on finding the clues to stop Type 1 diabetes. That's what took him to Sweden to meet with other researchers last month.

When he was there, he watched as that Swedish 2-year-old played with a tea set and poured an imaginary drink for her mother.

One day, she might have to learn how to use needles for insulin instead.

Krischer would rather see her making tea.

Lisa Greene can be reached at 813 226-3322 or lgreene@sptimes.com


Jeffrey Krischer

Who he is: professor and chief of the biostatistics and informatics division; director of the pediatrics epidemiology center, University of South Florida

Why he's the $189-million man: He uses computers to fight diabetes.

Age: 60.

Family: wife Jamie; daughters Mindy, 21, and Amy, 17.

Hobbies: "I grow orchids. I mean, I try to grow orchids. Orchids and I have this relationship. I do the best I can, and if they're not happy, they're free to leave."

To learn more about participating in the study, go to www.teddystudy.org.