Air Force Policy On Diabetes In 2020
The Air Force has similar regulations regarding diabetes like the Army.
The manual notes that is it imperative that the deliberations to deploy a service member with diabetes consider all the factors that can compromise the members safety and the ability to accomplish the mission.
Air Force regulations support the same method as the Army that anyone with a HbA1c of less than 7% is allowed to still get deployed with some careful considerations.
The Air Force supports the general stance of the U.S. military that if found fit for duty, the solider may not get deployed to areas where insulin cannot get properly stored.
Furthermore, there should be appropriate medical support for the individual as well.
Talk to an Air Force recruiter to find out which waiver, if any, would be necessary.
Telemedicine At Remote Locations
Through effective use of various telemedicine venues, we can communicate withsoldiers nearly anywhere in the world. Though not all deployments are approved, wenonetheless work to ensure all soldiers and their units have the ability to contactour medical team 24/7 in the event a soldier is cleared for such assignment. Interms of control, maintenance or slight increase in A1C to reduce risk ofhypoglycemia is preferred. An average glucose less than the renal threshold duringdeployment is sufficient, for example, 170 mg/dl or A1C of approximately 7.5. Wefeel this slight elevation in glycemic level, if it occurs, is reasonable in aneffort to prevent hypoglycemia.
We can also train soldiers who were diagnosed at another location. For instance, werecently trained a Special Forces soldier with type 1 diabetes who was sent to FortBragg for two days temporary duty for intensive insulin therapy and remotetechnology capabilities training. We now periodically monitor this soldier using theDexcom Follow App . Similarly, we can continue tomonitor Fort Bragg soldiers who are found fit for duty and then move to anotherlocation. With the cooperation of their local medical teams, we can continue fulldiabetes care for those who desire this arrangement.
Diabetes And The Military
If you have pre-diabetes, Type 1, Type 1.5 or Type 2 diabetes, its not as easy as simply joining the military. Questions may come up about your diabetic condition and even though it may seem discriminatory for the military to tell someone they cannot serve due to this condition, the military is known for rejecting people due to health issues.
Before we start to get too worried, its important to look at how military recruiting and diabetes relate. Its also important to look at what could happen if youre diagnosed with diabetes as a member of the military.
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Determination Of Military Readiness
The medical board is established by each branch of the U.S. Military in order to ensure each service member that joins the military is prepared and ready for any type of situation.
Soldiers are deployed into all types of dangerous situations and must demonstrate basic physical and mental readiness.
Unfortunately, diabetes can cause an unnecessary distraction in times of combat.
It can damage the cohesiveness of a squad, and also put other soldiers at risk if they are attending to your medical needs during combat.
Sadly, diabetes adversely affects the career of a soldier as certain opportunities for promotion and development are restricted or blocked because of the medical condition.
It may prevent you from being able to go on certain assignments which ultimately fosters a bad psyche.
The Army, like other branches of the military, likes to remind servicemembers that the world in which they exist is far different from the real world.
Anything that can get away from the single-minded objective of completing a mission is a serious risk.
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Abdominal Organs And Gastrointestinal System
The following conditions may disqualify you from military service:
a. Esophagus. Ulceration, varices, fistula, achalasia, or other dysmotility disorders; chronic or recurrent esophagitis if confirmed by appropriate X-ray or endoscopic examination.
b. Stomach and duodenum.
Gastritis. Chronic hypertrophic or severe.
Active ulcer of the stomach or duodenum confirmed by X-ray or endoscopy.
Congenital abnormalities of the stomach or duodenum causing symptoms or requiring surgical treatment, except a history of surgical correction of hypertrophic pyloric stenosis of infancy.
c. Small and large intestine.
Inflammatory bowel disease. Regional enteritis, ulcerative colitis, ulcerative proctitis.
Duodenal diverticula with symptoms or sequelae .
Intestinal malabsorption syndromes, including postsurgical and idiopathic.
Congenital. Condition, to include Meckel’s diverticulum or functional abnormalities, persisting or symptomatic within the past two years.
d. Gastrointestinal bleeding. History of, unless the cause has been corrected, and is not otherwise disqualifying.
e. Hepato-pancreatic-biliary tract.
Cirrhosis, hepatic cysts and abscess, and sequelae of chronic liver disease.
Cholecystitis, acute or chronic, with or without cholelithiasis, and other disorders of the gallbladder including post-cholecystectomy syndrome, and biliary system.
Note. Cholecystectomy is not disqualifying 60 days postsurgery , providing there are no disqualifying residuals from treatment.
f. Anorectal.
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Personality Conduct And Behavior Disorders
The following conditions may disqualify you for military service:
a. Personality, conduct or behavior disorders as evidenced by frequent encounters with law enforcement agencies, antisocial attitudes or behavior, which, while not sufficient cause for administrative rejection, are tangible evidence of impaired capacity to adapt to military service.
b. Personality, conduct or behavior disorders where it is evident by history, interview or psychological testing that the degree of immaturity, instability, personality inadequacy, impulsiveness or dependency will seriously interfere with adjustment in the Army as demonstrated by repeated inability to maintain reasonable adjustment in school, with employers and fellow workers, and with other social groups.
c. Other behavior disorders including but not limited to conditions such as authenticated evidence of functional enuresis or encopresis, sleepwalking or eating disorders that are habitual or persistent occurring beyond age 12, or stammering of such a degree that the individual is normally unable to express themselves clearly or to repeat commands.
d. Specific academic skills defects, chronic history of academic skills or perceptual defects, secondary to organic or functional mental disorders that interfere with work or school after age 12. Current use of medication to improve or maintain academic skills.
e. Suicide, history of attempted or suicidal behavior.
Can You Join The Military With Diabetes
January 16, 2018 By Ben Ehinger
Joining the military is a very noble and patriotic thing to do. Fighting to preserve the freedom of this great country is something many want to do, but can you join the military with diabetes?
Questions around military recruiting and diabetes have been asked for many years. There are multiple types of diabetes and even pre-diabetes to consider. If youre considering joining the military, but youre afraid because of diabetes, heres the information you seek.
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Sample Medical Conditions That Might Stop Or Delay Me Joining
Gastrointestinal problems:
- Chronic abdominal diseases like Crohn’s disease or ulcerative colitis.
- Significant history of dyspepsia.
- History of kidney problems such as malfunction of a kidney or kidney stones.
- Recurrent renal colic.
- Structural abnormalities of the spine and spinal cord.
- History of chronic or recurrent back pain.
Blood diseases:
- Disorders resulting in abnormal coagulation.
Bone or joint problems:
- Knee injuries and chronic knee pain.
- History of bone fractures.
- Shoulder problems resulting in functional limitations or restrictions of movement.
- Loss of a limb.
- Chronic joint diseases such as ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis or gout.
- Hypermobility syndrome.
- Symptomatic or medication-suppressed abnormal heart rhythms.
- Cardiomyopathy.
- Asthma .
- Chronic lung disease such as emphysema, bronchiectasis or cystic fibrosis.
- Tuberculosis.
- Current perforation of ear drum.
- Chronic ear diseases like cholesteatoma.
- Presence of eardrum ‘grommets’.
- Chronic eye conditions such as glaucoma, keratoconus and retinitis pigmentosa.
- Damage to the eyelids affecting vision.
- Chronic conjunctivitis.
- Reduction of corrected vision in one eye below army entry standards.
- Diplopia.
- History of head injury with neurological sequalae.
- Migraines.
- History of deliberate self-harm or suicide attempts.
Skin problems:
- An active skin disease like severe eczema or widespread psoriasis.
Other conditions:
Insulin Resistance Evolves To Type 2 Diabetes And Other Costly Disease
Insulin resistance has been brought to our attention with more and more studies, reports, Ted Talks, articles by doctors, and even an article I wrote, titled “Biggest Health Problem in the U.S.,” yet there are no significant programming or dieting changes recommended by the government health and medical community. There are, however, a few in the medical and nutrition field who have been waving the red flag for years as our country is now sporting 70 percent overweight or obese numbers.
Now, even our military is representing those numbers as more and more of the active duty members are overweight or obese. With a national type 2 diabetes and pre-diabetes rate of 37 percent, it is only a matter of time before our national crisis affects the pool of military candidates on a strategic level. In fact, Type 2 Diabetes has doubled in the last 10 years and quadrupled since 1980! Currently, the number one reason why young men and women cannot join the military is they fail to meet the height / weight and body fat percentage minimum standards. So our nations health and wellness has already started to affect recruiting numbers.
Insulin Resistant vs Insulin Sensitive
Who Is To Blame?
At some point, we can only blame this health crisis on our own habits of consuming too much sugar or over-eating.
How Do You Know if You Have Insulin Resistance?
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Staying Enlisted After A Diagnosis
The prospects for soldiers who are diagnosed with diabetes after enlisting are less negative and increasingly better as technology improves and diabetes comes to be better understood. Typically, if a soldier is diagnosed while already on active duty, they will be required to undergo a Medical Board Evaluation but may remain enlisted if they are found fit for duty.
Every branch of the U.S. military has established a medical board, whose duty it is to see that every service member who joins the military is mentally and physically prepared for any type of situation they could encounter in the course of their enlistment.
In the Army, soldiers are deployed into many dangerous situations, even if they are not in active combat. Issues arising from diabetes, whether they are longer-term health complications or more immediate situations such as fainting in the line of duty, may preclude the medical board from allowing a soldier to continue to serve. Medical board rulings regarding diabetic service members have varied depending on the specific board and the service member’s case.
The Military And Type 1 Diabetes More Of A Connection Than We Think
The military and Type 1 diabetes more of a connection than we think Happy Friday folks, I know Im in desperate need of a weekend! Im usually pretty lighthearted on Friday posts, but this time I need to turn your attention to a very specific sub-group of people with Type 1 diabetes. Do you know anyone who was serving in the military and diagnosed with Type 1 diabetes during or shortly after deployment? If so, they are not alone. Turns out this pattern of developing diabetes in conjunction with serving in the military is very common enough that some doctors, scientists, and concerned veterans are starting to explore this phenomenon in hopes that it leads to more information about why anyone develop Type 1 diabetes. A friend of mine started a Facebook group for folks in this sub-group of people with Type 1, and if you or someone you know was diagnosed during or after serving in the armed forces, Id recommend you join in on the discussion. In addition to exploring the mystery of the military-diabetes connection, this group could be influential in changing the resources available to people with diabetes in the military. And I am all for anything that helps folks with the betes. Click here for the info. On that noteis it happy hour yet? Its five oclock somewhere right?Continue reading >>
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Research Design And Methods
A total of 2,000 control subjects were selected at random and matched on a 4-to-1 basis by the following characteristics: age within 1 year, sex, branch of service , date of entry into the military within the same month, and active duty at the time the matched case received an initial diagnosis of diabetes . Control subjects did not have a diagnosis of diabetes or diabetes-related complications at the time of selection. Race/ethnicity was analyzed by three categories: non-Hispanic whites, African-Americans, and Hispanic/other, which included people of Hispanic origin and all others who did not report being of Caucasian or African-American descent . Rank was categorized into three classes: junior enlisted , senior enlisted , and officers . Rank is often used as a surrogate for socioeconomic status in epidemiologic studies of military populations and was hypothesized to be associated with diabetes in this study . This study was reviewed and approved by the Human Use Committee at the Walter Reed Army Institute of Research.
Can A Diabetic Join The Army Reserves
I had to resign from the naval reserves as a direct result. Hi i am currently serving in the british army.
Can You Join The Military With Diabetes It S Possible
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Military Stance On Diabetes And Active Duty
This is the hard stance of the military related to Type 1, Type 1.5 and Type 2 diabetes, and generally all branches of the military feel this way about a person with diabetes serving in combat. The general consensus is that you will not be able to make it through tough periods of combat, and that you will be a burden to others that are serving with you.
All branches of the military will not allow a Type 1, Type 1.5, or Type 2 diabetic to enlist. You can submit waivers, but you may still get a no. There are stories of automatic PDQs given out to those with pre-diabetes before a medical evaluation has been done, but it is unclear whether or not these persons were disqualified due to being overweight or obese, or some other factor such as a mental illness. If someone already in the military is diagnosed with Type 1 diabetes, they will be discharged unless that person can prove that they are fit for active duty.
There have been some rare cases where this has been done, and a Type 1, Type 1.5 or Type 2 military person has been allowed to remain in active duty, depending upon his or her military occupation. For example, someone with diabetes serving on a submarine, or piloting an aircraft would not be allowed to stay in active duty. There have been cases where someone has been reassigned to another occupation.
Military Service And Diabetes
There are few things more disappointing to a potential military recruit than to find out that they have diabetes and cannot sign up.
As one can imagine, military members need to be strong, healthy and free from any disability that would require attention while in the field. The equipment they carry into battle cannot include needles and insulin.
Potential Recruits
When someone makes the decision to join a branch of the military, they are subject to a battery of tests for aptitude, intelligence and strength. They also receive a full medical evaluation. It is here that recruits sometimes learn for the first time that they are pre-diabetic or diabetic.
While a diagnosis of diabetes requiring treatment is an automatic disqualification from enlistment, being pre-diabetic does not automatically rule out service in the military. Doctors will consult with the potential recruit to educate them on the changes they need to make in order to reduce their risk. They might ask them to institute their changes for a period of time – six months or a year – and then come back and re-apply. Assuming that they have improved their A1c numbers and are not in need of treatment, they could then be eligible to enlist.
Some may feel the exclusion of persons with diabetes from service in the military is discriminatory. Unfortunately, federal anti-discrimination laws don’t apply to the military.
Military Personnel
Serving with Diabetes
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What Are The Restrictions For A Person With Type 1 Diabetes Joining The Us Armed Forces If They Are Accepted Are There Any Limits To The Jobs Offered Them
Answer:
People with diabetes cannot join the US armed services at all at present. This is discriminatory, but nobody has yet successfully challenged the US law. Only Israel and Switzerland, to my knowledge, allow non-combatant positions for folks with diabetes. All the rest of the world does not allow people with diabetes to enlist or to stay in the service because of fears of lack of medication and/or insulin reactions during critical times. This is all archaic since there are more non-combatant positions than combatant positions except in full war situations and even then this could be arranged easily, but until somebody challenges this in court, things are unlikely to change.
SBAdditional comments from Dr. Donough OBrien:
I believe the answer is that you cannot enlist. See Military Enlistment Standards.
DOBAdditional comments from Dr. Frank Varon:
I am pretty sure it is considered a pre-existing medical condition and a disqualification from entering the Armed Forces.
FVAdditional comments from David Holtzman:
The questioner can contact their local Armed Forces Recruiting Center. They will have this information. The phone number for this office is in the phone book, listed under US Government.
Stuart J. Brink, MD,