Background: Young adults with type 1 diabetes (T1D) are exempt from conscript military service due to risk of severe hypoglycaemia and metabolic compromise. Nevertheless, there are patients who volunteer to military service.
Aims and objectives: To evaluate the effect of military service on metabolic control and incidence of acute diabetes complications.
Methods: Study design: retrospective, comparative analysis. Data of 145 T1D patients born between 1984 and 1992 and followed at the National Center of Childhood Diabetes was retrieved from the institutional registry. The study group included 76 (36 males (47.4%)) T1D conscript volunteers and 69 (38 males (55.1%)) T1D non-volunteers served as controls. Clinical and laboratory data was collected from medical records one year prior to enlistment to military service, at enlistment, after 1 and 2 years of service. Outcome measures: HbA1c, occurrence of severe hypoglycaemia or diabetic ketoacidosis (DKA), BMI-SDS and insulin dosage.
Results: Metabolic control was comparable in volunteers and non-volunteer controls (mean HbA1c (1 year prior to enlistment 7.83±1.52% vs 8.07%±1.63; at enlistment 7.89±1.36% vs 7.93±1.42%; 1 year after enlistment 7.81±1.28% vs 8.00±1.22%; 2 years after enlistment 7.62±0.8% vs 7.79±1.19%)); with no significant changes from baseline throughout follow-up. BMI status and insulin requirements were similar and remained unchanged in volunteers and controls (mean BMI-SDS (1 year prior 0.23±0.83 vs 0.29±0.95; at enlistment 0.19±0.87 vs 0.25±0.98; 1 year after 0.25±0.82 vs 0.20±0.96; 2 years after 0.20±0.87 vs 0.16±0.90) and mean insulin dose in U/kg per day (1 year prior 0.90±0.23 vs 0.90±0.37, at enlistment 0.90±0.28 vs 0.93±0.33, 1 year after 0.86±0.24 vs 0.95±0.33, 2 years after 0.87±0.23 vs 0.86±0.28)). There were no severe hypoglycaemia episodes and DKA events in both groups.
Conclusions: Our data suggests that young adults with T1D can maintain appropriate metabolic control during military service without significant weight change or severe acute diabetic complications.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology