Risk of Diabetes in U.S. Military Service Members in Relation to Combat Deployment and Mental Health

OBJECTIVE — Few prospective data exist on the risk of diabetes in individuals serving in the U.S. military. The objectives of this study were to determine whether military deployment, combat exposures, and mental health conditions were related to the risk of newly reported diabetes over 3 years. RESEARCH DESIGN AND METHODS — Data were from Millennium Cohort Study participants who completed baseline (July 2001–June 2003) and follow-up (June 2004– February 2006) questionnaires (follow-up response rate 71.4%). After exclusion criteria were applied, adjusted analyses included 44,754 participants (median age 36 years, range 18–68 years). Survey instruments collected demographics, height, weight, lifestyle, military service, clinician-diagnosed diabetes, and other physical and mental health conditions. Deployment was defined by U.S. Department of Defense databases, and combat exposure was assessed by self-report at follow-up. Odds of newly reported diabetes were estimated using logistic regression analysis. RESULTS — Occurrence of diabetes during follow-up was 3 per 1,000 person-years. Indi-viduals reporting diabetes at follow-up were significantly older, had greater baseline BMI, an