Risk of diabetes in U.S. military service members in relation to combat deployment and mental health
- PMID: 20484134
- PMCID: PMC2909060
- DOI: 10.2337/dc10-0296
Risk of diabetes in U.S. military service members in relation to combat deployment and mental health
Abstract
Objective: Few prospective data exist on the risk of diabetes in individuals serving in the U.S. military. The objectives of this study were to determine whether military deployment, combat exposures, and mental health conditions were related to the risk of newly reported diabetes over 3 years.
Research design and methods: Data were from Millennium Cohort Study participants who completed baseline (July 2001-June 2003) and follow-up (June 2004-February 2006) questionnaires (follow-up response rate = 71.4%). After exclusion criteria were applied, adjusted analyses included 44,754 participants (median age 36 years, range 18-68 years). Survey instruments collected demographics, height, weight, lifestyle, military service, clinician-diagnosed diabetes, and other physical and mental health conditions. Deployment was defined by U.S. Department of Defense databases, and combat exposure was assessed by self-report at follow-up. Odds of newly reported diabetes were estimated using logistic regression analysis.
Results: Occurrence of diabetes during follow-up was 3 per 1,000 person-years. Individuals reporting diabetes at follow-up were significantly older, had greater baseline BMI, and were less likely to be Caucasian. After adjustment for age, sex, BMI, education, race/ethnicity, military service characteristics, and mental health conditions, only baseline posttraumatic stress disorder (PTSD) was significantly associated with risk of diabetes (odds ratio 2.07 [95% CI 1.31-3.29]). Deployments since September 2001 were not significantly related to higher diabetes risk, with or without combat exposure.
Conclusions: In this military cohort, PTSD symptoms at baseline but not other mental health symptoms or military deployment experience were significantly associated with future risk of self-reported diabetes.
Figures
Similar articles
-
Newly reported hypertension after military combat deployment in a large population-based study.Hypertension. 2009 Nov;54(5):966-73. doi: 10.1161/HYPERTENSIONAHA.109.132555. Epub 2009 Sep 14. Hypertension. 2009. PMID: 19752293
-
Smokeless tobacco use related to military deployment, cigarettes and mental health symptoms in a large, prospective cohort study among US service members.Addiction. 2012 May;107(5):983-94. doi: 10.1111/j.1360-0443.2011.03737.x. Epub 2012 Jan 23. Addiction. 2012. PMID: 22126651
-
Factors associated with persistent posttraumatic stress disorder among U.S. military service members and veterans.BMC Psychiatry. 2018 Feb 17;18(1):48. doi: 10.1186/s12888-018-1590-5. BMC Psychiatry. 2018. PMID: 29452590 Free PMC article.
-
Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.Arch Gen Psychiatry. 2007 Jul;64(7):843-52. doi: 10.1001/archpsyc.64.7.843. Arch Gen Psychiatry. 2007. PMID: 17606818 Review.
-
Gender differences of postdeployment post-traumatic stress disorder among service members and veterans of the Iraq and Afghanistan conflicts.Epidemiol Rev. 2014;36:5-18. doi: 10.1093/epirev/mxt005. Epub 2013 Aug 29. Epidemiol Rev. 2014. PMID: 23988441 Review.
Cited by
-
Trauma, healthcare access, and health outcomes among Southeast Asian refugees in Connecticut.J Immigr Minor Health. 2013 Dec;15(6):1065-72. doi: 10.1007/s10903-012-9715-2. J Immigr Minor Health. 2013. PMID: 22976796 Free PMC article.
-
Post-traumatic stress disorder and cardiometabolic disease: improving causal inference to inform practice.Psychol Med. 2017 Jan;47(2):209-225. doi: 10.1017/S0033291716002294. Epub 2016 Oct 4. Psychol Med. 2017. PMID: 27697083 Free PMC article. Review.
-
Association Between Clinically Meaningful Posttraumatic Stress Disorder Improvement and Risk of Type 2 Diabetes.JAMA Psychiatry. 2019 Nov 1;76(11):1159-1166. doi: 10.1001/jamapsychiatry.2019.2096. JAMA Psychiatry. 2019. PMID: 31433443 Free PMC article.
-
Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta-analysis.Diabet Med. 2018 Jun;35(6):677-693. doi: 10.1111/dme.13606. Epub 2018 Mar 25. Diabet Med. 2018. PMID: 29460506 Free PMC article.
-
Circulating cell-free mitochondrial DNA levels and glucocorticoid sensitivity in a cohort of male veterans with and without combat-related PTSD.Transl Psychiatry. 2024 Jan 10;14(1):22. doi: 10.1038/s41398-023-02721-x. Transl Psychiatry. 2024. PMID: 38200001 Free PMC article.
References
-
- Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med 2004;351:13–22 - PubMed
-
- Cosgrove MP, Sargeant LA, Griffin SJ. Does depression increase the risk of developing type 2 diabetes? Occup Med (Lond) 2008;58:7–14 - PubMed
-
- Goodwin RD, Davidson JR. Self-reported diabetes and posttraumatic stress disorder among adults in the community. Prev Med 2005;40:570–574 - PubMed
-
- Black PH. The inflammatory consequences of psychologic stress: relationship to insulin resistance, obesity, atherosclerosis and diabetes mellitus, type II. Med Hypotheses 2006;67:879–91 - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical