S20 • FEDERAL PRACTITIONER • JULY 2017 www.fedprac.com
Diabetes Mellitus
Diabetes mellitus (DM) is the seventh leading cause of
death in the U.S., but after decades of rapid growth,
both the incidence and prevalence appear to have
leveled off. The VA spends $1.5 billion annually to
treat patients with DM. Veterans are 2.5 times more
likely than nonveterans to have diabetes, and many
have comorbid conditions, including obesity, hypoglycemia, hypertension, dyslipidemia, cardiovascular
disease, stroke, blindness, kidney disease, and
amputations. Obesity and DM remain closely related,
and more than two-thirds of women veterans with
DM also have obesity.
A number of factors seem to increase the risk of
type 2 DM for veterans. For example, DM is associ-
ated with exposure to herbicides, such as Agent
Orange; past physical strain with chronic pain, and
degenerative joint damage. Certain factors also
increase risk of obesity, such as advanced age and
low income, as well as limited access to healthy and
high-quality foods. High-risk ethnic groups for
diabetes include African Americans, Hispanics,
Native Americans, Asians, and Pacific Islanders.
Veterans with prediabetes, hypertension, low high-density lipoprotein cholesterol levels, high triglyceride
levels, and insufficient physical activity also are at
increased risk.
EVERY 23 SECONDS
someone in the U.S. is
diagnosed with diabetes
Diabetes Diagnosis1