Combat veterans risk of type 2 diabetes increases with severity of injuries, study finds

Soldiers are more likely to develop several chronic diseases, including type 2 diabetes, if they are severely injured in combat, according to new research.
The American study, conducted by researchers at the Clinical Investigation Facility at David Grant Medical Centre, Travis Air Force Base in California, is among the first to examine the impact of military service on the risk of chronic diseases; something often described as a “hidden cost” of armed conflict.
The researchers examined the data of 3,846 soldiers using the Injury Severity Score (ISS). They then compared this data to available data on the subsequent development of chronic health conditions, including type 2 diabetes. All injuries examined in the study were sufficiently severe to require intensive care.
The ISS records injury severity on a scale of 1 to 75. 1 is a minor injury, 75 is an injury so severe that the soldier is unlikely to survive it. Every five ISS points increase in the severity of a soldier’s injury correlated with a 13 per cent increase in their likelihood of developing type 2 diabetes, a six per cent increase in the risk of coronary artery diseases, and a 15 per cent increase in the risk of chronic kidney disease.
It is possible that post-traumatic stress disorder (PTSD), commonly developed by severely injured soldiers, could increase the risk of type 2 diabetes through an inflammatory response. PTSD might also heighten the risk of diet-related type 2 diabetes, because PTSD patients are more likely to gain weight and fall into substance abuse.
“The more severely a service member is injured, the more likely they are to develop a wide variety of chronic medical conditions, including high blood pressure, [type 2] diabetes, chronic kidney disease and hardening of the arteries,” said Major Ian J. Steward, MD, lead author of the study.
“I have seen firsthand that our soldiers, sailors, airmen and marines get the finest trauma and follow-up care. Our study lays important ground work to better understand the longer-term effects of combat-related injury on the risk of chronic disease.”
The findings are published in the American Heart Association journal Circulation.