Diabetes by Air, Land, and Sea: Effect of Deployments on HbA1c and BMI

Abstract Introduction Service members (SMs) in the United States (U.S.) Armed Forces have diabetes mellitus at a rate of 2–3%. Despite having a chronic medical condition, they have deployed to environments with limited medical support. Given the scarcity of data describing how they fare in these set...

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Bibliographic Details
Published in:Military medicine 2020-03, Vol.185 (3-4), p.486-492
Main Authors: Folaron, Irene, True, Mark W, Kazanis, William H, Wardian, Jana L, Tate, Joshua M, Graybill, Sky D, Clerc, Philip G, Jenkins, Craig R
Format: Article
Language:English
Subjects:
Body Mass Index
Diabetes
Diabetes Mellitus - drug therapy
Glucose
Glycated Hemoglobin A - analysis
Glycated Hemoglobin A - therapeutic use
Hemoglobin
Humans
Military deployment
Military Medicine
Military Personnel
Prospective Studies
Retrospective Studies
United States - epidemiology
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Summary:Abstract Introduction Service members (SMs) in the United States (U.S.) Armed Forces have diabetes mellitus at a rate of 2–3%. Despite having a chronic medical condition, they have deployed to environments with limited medical support. Given the scarcity of data describing how they fare in these settings, we conducted a retrospective study analyzing the changes in glycated hemoglobin (HbA1c) and body mass index (BMI) before and after deployment. Materials and Methods SMs from the U.S. Army, Air Force, Navy, and Marine Corps with diabetes who deployed overseas were identified through the Military Health System (MHS) Management Analysis and Reporting Tool and the Defense Manpower Data Center. Laboratory and pharmaceutical data were obtained from the MHS Composite Health Care System and the Pharmacy Data Transaction Service, respectively. Paired t-tests were conducted to calculate changes in HbA1c and BMI before and after deployment. Results SMs with diabetes completed 11,325 deployments of greater than 90 days from 2005 to 2017. Of these, 474 (4.2%) SMs had both HbA1c and BMI measurements within 90 days prior to departure and within 90 days of return. Most (84.2%) required diabetes medications: metformin in 67.3%, sulfonylureas in 19.0%, dipeptidyl peptidase-4 inhibitors in 13.9%, and insulin in 5.5%. Most SMs deployed with an HbA1c 
ISSN:0026-4075
1930-613X
DOI:10.1093/milmed/usz311