title: Weighing in on type 2 diabetes in the military: characteristics of U.S. military personnel at entry who develop type 2 diabetes.
abstract: OBJECTIVE
  Current incidence trends in type 2 diabetes portend a significant public health burden and have largely been attributed to similar trends in overweight and physical inactivity. Medical surveillance of the U.S. military 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 determinants of diabetes have not been studied in the military population, which may provide novel clues to the increasing incidence of diabetes in the U.S.
  
  
  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 status, and BMI and blood pressure at entry into military service with the subsequent development of type 2 diabetes.
  
  
  RESULTS
  Increased BMI (adjusted odds ratio, 3.0 for the > or =30 kg/m(2) vs. < or =20 kg/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 diabetes.
  
  
  CONCLUSIONS
  Individuals with type 2 diabetes in the U.S. military have risk factors similar to the general U.S. population. Because diabetes is a preventable disease, it is of concern that it is occurring in this population of younger and presumably more fit individuals. This has significant implications for the prevention of diabetes in both military and civilian populations.
authors.affiliation: Walter Reed Army Institute of Research, Silver Spring, Maryland 20910-5100, USA. robert.paris@amedd.army.mil
authors.forename: R M
authors.initials: RM
authors.lastname: Paris
authors.forename: S A
authors.initials: SA
authors.lastname: Bedno
authors.forename: M R
authors.initials: MR
authors.lastname: Krauss
authors.forename: L W
authors.initials: LW
authors.lastname: Keep
authors.forename: M V
authors.initials: MV
authors.lastname: Rubertone
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004522:Educational Status; D005006:Ethnicity; D006801:Humans; D016013:Likelihood Functions; D008887:Military Medicine; D016017:Odds Ratio; D044469:Racial Groups; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology