Abstract
Type 1 diabetes mellitus (T1DM) is an increasingly encountered chronic illness in Saudi Arabia. It is known to have an immune-mediated pathogenesis, which results in the loss of insulin-secreting beta-cells responsible for maintaining normal blood glucose levels. The three main autoantibodies identified to play a role in the pathogenesis are islet cell antibodies (ICA), insulin autoantibodies (IAA) and glutamic acid decarboxylase antibodies (GAD). This study aims to determine at what age during childhood the autoantibodies ICA, IAA and GAD are most prevalent, and identify any correlation between their presence and the severity of the initial clinical presentation. Medical records of children diagnosed with T1DM in Riyadh in 2000-2007 were reviewed, and a total of 98 patients were included in the study (age range: 1-12 years, mean: 6.6 years, equal numbers by gender), of which 49% presented with diabetic ketoacidosis (DKA). Results showed that 67% were positive for ICA, 36% for IAA and 84.4% for GAD. The presence of ICA was predominant in children aged under six years. The presence of ICA and GAD in the absence of IAA was associated with more severe clinical presentation.