Research Article

Assessment of Serum Ferritin Levels in Patients with Type 1 and Type 2 Diabetes Mellitus

Abstract

Background: Diabetes Mellitus (DM) is a metabolic disease of chronic hyperglycemia. New evidence suggests that iron metabolism, specifically serum ferritin, is involved in its pathogenesis. Objectives: To evaluate and compare serum ferritin levels in patients with Type 1 DM (T1DM), Type 2 DM (T2DM) and healthy controls and to determine independent predictors of raised ferritin by multivariable analysis. Methods: 75 patients (29 T1DM, 21 T2DM and 25 age and sex matched healthy controls) were recruited in a cross-sectional study. Serum ferritin, HbA1c, C-peptide, transferrin saturation (TSAT) and fasting blood sugar were determined. One-way ANOVA test with Bonferroni post hoc test, Pearson’s correlation and multiple linear regression (MLR) were used for data analysis. Normality was confirmed using the Shapiro-Wilk test and effect sizes are expressed as Cohen’s d. Results: Ferritin was significantly elevated in T2DM (193.3 ± 65.4 ng/mL) compared to both T1DM (55.4 ± 32.1 ng/mL) and controls (62.1 ± 28.7 ng/mL), both P <0.001. There is no significant difference between the ferritin levels of T1DM and control (P = 0.84). MLR identified diabetes type (β = 0.61, P <0.001) and BMI (β = 0.22, P = 0.014) as the strongest independent predictors of ferritin (R2 = 0.71). When confounders were taken into account, HbA1c was not an independent predictor (P = 0.152). Conclusion: Hyperferritinemia in T2DM is mainly due to insulin resistance and adiposity, not glycemic dyscontrol. Ferritin testing in T2DM may be useful to identify patients with greater inflammatory and oxidative risk, who should be studied over the long term. What is known: There is a link between iron metabolism and oxidative stress in diabetes mellitus. What is new: Factors influencing diabetes mellitus and iron metabolism include HbA1C, total iron binding protein, and serum ferritin. 

Authors affiliation:

Zainab Abdul Abbas Nasser (ORCID): Department of Pathological Analysis, Faculty of Science, Kufa University, Najaf, Iraq. 
Ali Nahedh Abdulameer (ORCID): Department of Pathological Analysis, Faculty of Science, Kufa University, Najaf, Iraq. 
Baneen Ali Abdulrahman (ORCID): Jabir ibn Hayyan for Medical and Pharmaceutical Sciences, Najaf, Iraq.
Mostafa Arkan Altayar (ORCID): Department of Pathological Analysis, Faculty of Science, Kufa University, Najaf, Iraq.  

How To Cite: Z.A.A. Nasser, A.N. Abdulameer, B.A. Abdulrahman and M.A. Altayar. Assessment of Serum Ferritin Levels in Patients with Type 1 and Type 2 Diabetes Mellitus. Journal of Biomedicine and Biosensors, 6(3):50–56, 2026. https://doi.org/10.58613/jbb636