Are Military Veterans at Higher Risk for Type 2 Diabetes?

What you need to know

Older veterans (born before 1960) have a slightly higher risk of developing type 2 diabetes compared to non-veterans
Veterans born after 1960 do not have an increased risk of type 2 diabetes
Veterans with post-traumatic stress disorder (PTSD) have a higher risk of developing type 2 diabetes

Background on Type 2 Diabetes

Type 2 diabetes is a chronic condition that affects how your body processes glucose (sugar). It occurs when your body becomes resistant to insulin or doesn’t produce enough insulin. Insulin is a hormone that helps glucose enter your cells to be used for energy.

Type 2 diabetes is a major public health concern, with rates doubling in the past 30 years in many countries. It can lead to serious complications like heart disease, kidney problems, and vision issues if not properly managed. Known risk factors include obesity, family history, and certain ethnicities.

While we know quite a bit about diabetes risk in the general population, less is known about how military service might impact diabetes risk later in life. To better understand this, researchers in Scotland conducted a large study comparing diabetes rates between veterans and non-veterans.

The Study: Comparing Veterans to Non-Veterans

The researchers used health records to look at over 78,000 veterans and 252,000 non-veterans in Scotland. They tracked these individuals for up to 37 years to see who developed type 2 diabetes.

Some key aspects of the study:

It included veterans born between 1945 and 1995
The non-veteran group was matched to be similar in age, sex, and area of residence
Data came from national health registers and hospital records
The researchers looked at overall diabetes risk as well as how it differed by factors like age and length of military service

Key Findings: Differences in Diabetes Risk

Overall Risk

The study found that 7.2% of veterans developed type 2 diabetes, compared to 6.4% of non-veterans. This translates to veterans having about an 8% higher risk overall.

However, this increased risk was not seen across all veterans. The higher risk was mainly found in older veterans - those born before 1960. For veterans born after 1960, there was no significant difference in diabetes risk compared to non-veterans.

Risk by Age Group

Veterans born before 1960: 11% higher risk of diabetes
Veterans born 1960 or later: No increased risk

This pattern mirrors what the researchers have seen for other health conditions in veterans, like heart disease. It suggests that changes in military health practices starting in the late 1970s may have had lasting positive effects on veteran health.

Risk by Length of Service

For the older veterans (born before 1960) who did have increased risk:

The higher risk was seen regardless of how long they served, except for those with the longest service (16+ years)
Those who served 16+ years did not have a significantly higher risk than non-veterans

For younger veterans (born 1960 or later):

No increased risk was seen for any length of service group
There was a slight, but not statistically significant, increase for those who left service very early in their careers

Risk Over Time

The researchers also looked at how the relative risk for veterans has changed over time. They found that:

The excess risk for veterans was highest in the early 1980s
Since the late 1980s, there has been little to no increased risk for veterans compared to non-veterans
This pattern has remained steady for the past 25 years

This suggests that whatever factors might have increased diabetes risk for older veterans are no longer relevant for more recent service members.

Mental Health and Diabetes Risk

An important finding from this study was a link between post-traumatic stress disorder (PTSD) and diabetes risk, especially in veterans:

Veterans with PTSD were twice as likely to be hospitalized for PTSD compared to non-veterans with PTSD
12.1% of veterans with PTSD had type 2 diabetes, compared to 9.4% of non-veterans with PTSD
The risk was even higher for those with both PTSD and mood disorders

This connection between PTSD and diabetes has been seen in other studies, particularly in U.S. veterans. While the exact reasons aren’t clear, chronic stress and inflammation may play a role. It’s also possible that some of the behaviors associated with PTSD (like poor sleep or unhealthy eating habits) could increase diabetes risk.

What This Means for Veterans and Healthcare Providers

For older veterans (born before 1960):

There is a slightly increased risk of type 2 diabetes
Extra attention to diabetes prevention and screening may be warranted
Lifestyle factors like maintaining a healthy weight, exercising regularly, and eating a balanced diet are especially important

For younger veterans (born 1960 or later):

There does not appear to be an increased diabetes risk related to military service
The same general diabetes prevention advice for the public applies

For all veterans with PTSD:

Healthcare providers should be aware of the potential increased diabetes risk
Screening for diabetes may be especially important
Managing PTSD symptoms and adopting healthy lifestyle habits could potentially help reduce diabetes risk

For healthcare providers:

When treating veterans with PTSD, be sure to consider the possibility of diabetes or prediabetes
A holistic approach that addresses both mental and physical health is important

Conclusions

This large, long-term study provides valuable insights into diabetes risk for military veterans:

Older veterans have a slightly higher risk of type 2 diabetes
Younger veterans do not appear to have an increased risk
The overall trend shows no evidence of increasing risk for veterans over the past 25 years
There is an important link between PTSD and diabetes risk that deserves attention

While the study was conducted in Scotland, the findings are likely relevant to veterans in other countries as well. The results highlight the importance of diabetes prevention efforts for older veterans and the need for comprehensive care that addresses both the physical and mental health of all veterans.