Autoantibodies as Predictive Markers in Type 1 Diabetes: Insights from Iraqi Patients

Abstract

Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by the destruction of pancreatic β-cells, often preceded by the appearance of circulating autoantibodies. These autoantibodies, including those against glutamic acid decarboxylase (GAD), insulinoma-associated antigen-2 (IA-2), and insulin (IAA), are valuable biomarkers for predicting, diagnosing, and monitoring the disease. Data on their prevalence in Iraqi patients remain limited. Objectives: This study aimed to determine the frequency of GAD, IA-2, and insulin autoantibodies in Iraqi children and adolescents with T1DM and evaluate their relationship with demographic, clinical, and disease-related parameters. Methods: A total of 100 Iraqi T1DM patients (aged 1–40 years) and 50 healthy age- and sex-matched controls were enrolled. Serum autoantibodies were detected using standardized ELISA kits. Associations between antibody prevalence and age, gender, disease duration, and family history were analyzed statistically. Results: Autoantibodies were significantly more frequent in T1DM patients compared to controls: GAD (58% vs. 4%, p < 0.0001), IA-2 (32% vs. 0%, p = 0.0022), and IAA (35% vs. 0%, p = 0.0010). Antibody prevalence did not differ by age or gender. However, patients with a shorter disease duration (≤10 years) showed significantly higher positivity rates. Insulin autoantibodies were strongly associated with diabetic ketoacidosis at onset. Conclusions: Autoantibodies against GAD, IA-2, and insulin are common among Iraqi T1DM patients and provide clinically valuable diagnostic and predictive information. Their prevalence patterns differ from Western populations, reflecting possible genetic and environmental influences. Routine screening and regional studies are recommended to improve early detection and preventive strategies in at-risk groups.