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USF Scientist Lives To Demystify Diabetes

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By ADAM EMERSON, The Tampa Tribune

Published: November 11, 2007

TAMPA - Every day, about 3,700 families in four countries play out a ritual orchestrated by a nondescript office in Tampa: Whatever their children eat, whenever they sneeze and sniffle, they are recording the evidence and waiting for the day a doctor may tell them their child has diabetes.

The records they keep will do nothing to prevent their children from getting the disease.

Instead, the evidence will join samples of their child's blood, stool and toenail clippings. The resulting data fall to a researcher at the University of South Florida who will analyze the information to help learn what causes diabetes - and thus help prevent it from afflicting others.

The researcher, Jeffrey Krischer, has won USF nearly $200 million in federal grants to keep the entire project humming in an air-conditioned room stacked high with more than 60 computer servers.

They hold the efforts of the families and researchers from as far away as Finland. And the federal government is investing millions in the enterprise.

Scientists will follow these families for 15 years, trying to learn what in a child's environment triggers a disease known since the time of the Pharaohs. Krischer links them all.

For USF leaders, Krischer's talent in attracting the largesse of the National Institutes of Health paves the way toward national prominence. To diabetes researchers worldwide, Krischer is the go-to person with the statistical know-how to predict who may develop the disease.

"He's relatively irreplaceable," said Jay Skyler, associate director of the University of Miami's Diabetes Research Institute. "When you take him out of the equation, you end up with a team that just doesn't have the effectiveness of what we've come to expect with Jeff."

Last month, Krischer, 60, received a $169 million grant from the NIH to continue the study identifying the triggers of Type 1 diabetes, once known as juvenile diabetes, for a project called The Environmental Determinants of Diabetes in the Young, or TEDDY. It was USF's largest research award ever.

In the end, Krischer said the federal government will infuse a quarter-million dollars into USF's role in TEDDY, a study that will enroll 8,000 children genetically at risk of developing Type 1 diabetes.

Tying It All Together

But TEDDY is not all Krischer and his staff of 50 coordinate in an office at USF's Research Park. It doesn't even occupy most of their time.

There's the study Krischer is coordinating that aims to prevent the onset of Type 1 diabetes and determine whether breast-feeding protects at-risk children. Researchers are watching 2,100 babies in 15 countries. He is also coordinating an effort aimed at arresting the progress of the disease in people who have it.

Researchers everywhere feed Krischer and his team data for analysis. The NIH, the U.S. Department of Defense and other federal agencies subsidize his work, which also includes the data coordination for studies of rare diseases, with as much as $30 million in grants every year.

Although he disagrees that he's irreplaceable, the Harvard-trained pediatrics professor concedes that none of these studies would survive without a coordinating center like his. "I tie all of these efforts together," he said last week.

It is his work with TEDDY, however, that has placed USF in the center of Type 1 diabetes study worldwide. The study is in its sixth year. In 2005, Krischer nabbed a $20.1 million NIH grant to further develop his work crunching the data researchers supply him to identify the causes of diabetes.

With that award, USF shot above Yale and Stanford universities in the amount of money the NIH awards for pediatrics research.

The $169 million award Krischer won guarantees that his role in TEDDY will continue at least another 10 years.

Fifteen of the 3,700 children enrolled have contracted the disease, and Krischer correctly predicted the outcome. Through his statistical formulas, he surveys the data from 1 million biological specimens - the blood, the stool, the toenail clippings - and displays them on his computer screen like a musical score.

He doesn't look at individual test subjects, but instead groups them and calculates commonalities. All of the children are at risk of contracting the disease, but many won't develop it. Discovering why some do and why some don't is at the heart of the study.

Type 1 diabetes can occur at any age, but commonly is diagnosed from infancy to the late 30s, the Juvenile Diabetes Research Foundation says. In this type, which afflicts 3 million people in the United States, a person's pancreas produces little or no insulin.

Scientists now think environmental factors, including infections and diet - particularly the introduction of cow's milk to infants in the first few months of life - raise the risk of diabetes.

'A Good Way To Spend Your Life'

Krischer's work in pediatrics goes back to the Miami native's days at the University of Florida, where he was a professor. In 1993, Krischer joined the H. Lee Moffitt Cancer Center & Research Institute, where he served as associate director of cancer control.

After USF health sciences Vice President Stephen Klasko came to the university in 2004, he found that Krischer was doing things "that went way beyond cancer," Klasko says.

Krischer then permanently moved into his USF office in the Research Park. Nowadays, he and Klasko are planning an expansion of his office space and staff. Krischer hopes to open a clinic in Tampa to extend his studies to local diabetes patients.

"You only have a fixed amount of time on this planet," Krischer said. Everybody in his office, he added, "feels like this is a good way to spend your life. As far as I'm concerned, I'm going to spend it wisely."

For USF, Klasko said the benefits go far beyond the money for Krischer's grants.

When you're looking for the best work in genetics, you think of places like Johns Hopkins University, Klasko said. When you're looking for the best in medical research data development, Klasko anticipates that scientists will be talking about Tampa, and that will make it easier to attract top faculty members.

"Our goal is to leverage the fact that (A), we have Dr. Krischer, and (B), the NIH doesn't give $169 million to institutions that aren't great," Klasko said.

Reporter Adam Emerson can be reached at (813) 259-8285 or aemerson@tampatrib.com.

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