Introduction: Although it is possible to
identify the genetic risk for type 1 diabetes (T1D), it is not possible to
predict who will develop the disease. New biomarkers are needed that would help
understand the mechanisms of disease onset and when to administer targeted
therapies and interventions. 

Areas Covered: An overview is
presented of international study efforts towards understanding the cause of T1D,
including the collection of several extensive temporal sample series that
follow the development of T1D in at risk children. The results of the proteomics
analysis of these material are presented, which have included bodily fluids,
such as serum or plasma and urine, as well as tissue samples from the pancreas.

Expert Commentary: Promising recent reports have indicated
detection of early proteomic changes in the serum of patients prior to
diagnosis, potentially providing new measures for risk assessment.  Similarly, there has been evidence that post-translationally
modifications may result in the recognition of islet cell proteins as
autoantigens; proteins thus modified could be used as targets for immunomodulation
to overcome the threat of autoimmune response.