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Diabetes in Veterans

Diabetes mellitus, specifically type II diabetes, is a pressing challenge for the Department of Veterans Affairs (VA). Characterized by chronic high blood sugar levels, diabetes poses a significant health threat to all who are diagnosed. It is estimated diabetes affects approximately 2 million veterans with veterans being 1.5 times more likely to develop type II diabetes compared to the general population. Prevalence of the disease within the VA system is steadily rising partly due to the demographic profile served, but also due to time taken by providers to increase awareness of and test for the disease, which naturally leads to more identified cases.

Comprehensive diabetes management is integrated into VA’s primary care services. Offering routine monitoring, education, and medication adjustments, providers support both individuals with pre-diabetes and type II diabetes diagnosis during primary care appointments. For complex disease management, primary care providers can refer their patients to specialist care with endocrinologist and dietitians.

Since diabetes is a prevalent medical issue within the VA, innovative research is spread throughout the health care system. Research initiatives range from the study of military-related risk factors to novel treatments (such as new medicines and new technologies) to precision medicine (i.e., how an individual’s genetic profile influences the course of the disease). For example, VA San Diego involved an academic partner to investigate blood pressure control strategies to prevent cardiovascular complications within the diabetic veteran population. At the same time, VA Boston collaborated with an academic partner to analyze data from self-management programs within the VA to find specific influences that resulted in better outcomes for the patient.  

Research within the VA is conducted with the intent and purpose of creating or improving programs that benefits its diabetic veteran population. When studies found intensive support for veterans who struggle with persistently high blood sugar levels resulted in significantly reduce HbA1C levels in these veterans for many years, the VA implemented the Advanced Comprehensive Diabetes Care (ACDC) program that started at one facility and is now available at 15+ VA facilities. When a provider believes an individual would benefit from support outside the standard VA care regiments, the ACDC program provides a telehealth-based intervention. VA nurses review the results from the veteran’s self-tracked home monitoring device during regular phone consultations and provide personalized support, including additional education, to help the veteran better manage their condition. Under the consultation and direction of diabetes specialists, these nurses can also support medication adjustments.

Representing a significant and complex challenge, the VA strives to educate its veteran population on the unique diabetes risk-factors they face and support those diagnosed with comprehensive support programs, ongoing research, and innovative technologies.


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