A low key figure in the halls of the Diabetes Center at UCSF, Dr. Steinunn Baekkeskov, Professor of Medicine and Microbiology/Immunology, and Faculty Member of the Diabetes Center is renowned the world over as the "Mother of Type 1 Diabetes Prediction. " How did she come to inherit such a grand title?

Well, autoantibodies associated with beta cell destruction can be present up to several years before the clinical onset of the disease. In effect, they are indications that there is an active autoimmune attack launched against a person's beta cells. As such, they are excellent markers of disease development and can provide a window for interventional treatments while patients still retain some insulin producing ability in their beta cells. However, they can only be analyzed accurately if the beta cell protein they recognize, i.e. target autoantigen is known. The international diabetes community currently recognizes that there are three main beta-cell-targeted autoantigens: GAD 65, IA-2, and glima 38.

Remarkably, two of these three antigens, GAD 65 and glima 38, were discovered by Dr. Baekkeskov and her UCSF research team. The third, IA-2, was discovered by Dr. Michael Christie - one of Dr. Baekkeskov's former trainees!

GAD 65, discovered in 1990, was a true breakthrough in predicting type 1 diabetes - autoantibodies to GAD 65 appear in 70-80% of newly diagnosed patients; those to IA-2 and glima 38 appear 50-60% and 20% of the time, respectively. The identification of these autoantibodies enabled the National Institutes of Health to launch their groundbreaking Diabetes Prevention Trial 1 (DPT-1) which screened first degree relatives of type 1 diabetics to determine their risk of developing diabetes. In addition, the discovery of these autoantigens has allowed the development of much more sensitive testing for diabetes risk - tests that are now used routinely across the world. GAD65 may also present unique opportunities for the development of new preventative therapies for diabetes.

Since Dr. Baekkeskov identified the main target autoantibodies, she has focused her efforts on understanding why GAD 65 and IA-2 are attacked by the body's own immune system. Her lab is also working on the creation of a new animal model that will help to develop prediction and prevention protocols. Currently, she is creating a humanized mouse model that possesses human tissue types as a possible replacement to the NOD (non-obese diabetes) mouse that is currently used in diabetes research labs throughout the world. If her track record is any indication, we'll be expecting to hear more great things from Dr. Baekkeskov in the near future.