Autoantibody Status at Diagnosis in Children and Adolescents with Type 1 And Type 2 Diabetes Attending the Paediatric Diabetes Care and Research Center (PDRC) in Bangladesh

Background: The rising prevalence of T1D and T2D in South Asia has created diagnostic challenges due to overlapping clinical features, underscoring the need for diabetes-associated autoantibodies (DAA) testing.Objective: To evaluate the prevalence of GAD and IAA and their clinical and biochemical correlates in Bangladeshi children and adolescents with newly diagnosed diabetes.Methods: A cross-sectional study was conducted among 91 children (aged 1-19 years) with newly diagnosed diabetes at the Paediatric Diabetes Care and Research Center (PDRC), BIRDEM, Bangladesh (2019-2022), classified as T1D or T2D using international and local criteria.Clinical, biochemical, and immunological data were extracted from records, with GADA and IAA measured within six months of diagnosis.Results: Of the 91 participants, children with T2D were older at diagnosis (median 11.5 vs. 9.0 years, p = 0.0001), more likely to have a family history of diabetes (98% vs. 84%, p = 0.031), and had higher C-peptide levels (2.69 vs. 0.45 ng/mL, p = 0.0001).DKA at onset was more common in T1D (30% vs. 5%, p = 0.003).Autoantibody positivity (≥1 DAA) was observed in 76% of T1D and 22% of T2D patients (p = 0.0001).GADA positivity was found in 58.0% of T1D and 19.5% of T2D, while IAA was positive in 42.0% of T1D and 12.2% of T2D.Conclusion: This study highlights lower DAA prevalence in Bangladeshi children with T1D compared to Western cohorts and reveals that many clinically suspected T2D cases also harbor antibodies, underscoring diagnostic complexity in South Asia.