Weighing in on type 2 diabetes in the military - Characteristics of US military personnel at entry who develop type 2 diabetes

OBJECTIVES - Current incidence trends in type 2 diabetes portend a signific ant public health burden and have largely been attributed to similar trends in overweight and physical inactivity. Medical surveillance of the U.S. mi litary indicates that the incidence of all types of diabetes is similar to that in the civilian population (1.9 vs. 1.6 cases per 1,000 person-years) despite weight and fitness standards. Differences in the common determinant s of diabetes have not been studied in the military population, which may p rovide novel clues to the increasing incidence of diabetes in the U.S. RESEARCH DESIGN AND METHODS- A case-control study, 4-to-1 matched for age, sex, entry date, time in service, and service component (e.g., Army, Navy), was used to describe the association of race/ethnicity, socioeconomic stat us, and BMI and blood pressure at entry into military service with the subs equent development of type 2 diabetes. RESULTS - increased BMI (adjusted odds ratio, 3.0 for the greater than or e qual to 30 kg/m(2) VS. less than or equal to 20 k g/m(2) categories and 2.0 for the 25.0-29.9 kg/m(2) category, compared with the reference category), African-American (adjusted odds ratio, 2.0) and Hispanic origin (adjusted odds ratio, 1.6) compared with white race and rank (adjusted odds ratio for junior enlisted versus officers, 4.1) were all associated with type 2 diab etes. CONCLUSIONS - Individuals with type 2 diabetes in the U.S. military have ri sk factors similar to the general U.S. population. Because diabetes is a pr eventable disease, it is of concern that it is occurring in this population of younger and presumably more fit individuals. This has signicant implica tions for the prevention of diabetes in both military and civilian populati ons.