Background: Helicobacter pylori infection is one of the most prevalent chronic bacterial infections. Several studies suggest a possible association between H. pylori infection and type 2 diabetes mellitus (T2DM), potentially mediated by chronic inflammation and metabolic dysregulation. This study aimed to evaluate the association between T2DM and active H. pylori infection among patients in Kirkuk City, Iraq.
Methods: This cross-sectional study was conducted at the Consulting Clinic of Azadi Teaching Hospital, Kirkuk, Iraq, between April 2022 and January 2023. A total of 185 participants aged 18–77 years were enrolled, including 112 patients with T2DM and 73 non-diabetic individuals. H. pylori infection was detected using a stool antigen immunochromatographic test. Data were analyzed using IBM SPSS Statistics version 26. Categorical variables were compared using Fisher’s exact test, and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Stratified analyses were performed according to gender, age group, and smoking status. 
Results: The mean age of participants was 48.6 ± 13.2 years. H. pylori positivity was observed in 82/112 (73.2%) patients with T2DM and 38/73 (52.1%) non-diabetic individuals. The crude OR for H. pylori infection among T2DM patients compared with non-diabetic participants was 2.52 (95% CI: 1.35–4.69; P = 0.004). Stratified analyses showed a generally consistent direction of association across subgroups, although statistical significance was not observed in all strata. Only crude ORs were calculated, and no adjusted analysis was performed. Therefore, the results may be affected by confounding factors and cannot establish an independent association. 
Conclusion: Stool antigen-confirmed H. pylori infection was more prevalent among patients with T2DM than among non-diabetic participants in this cross-sectional study.