RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0039-3400215
Diabetes-Care Quality among Veterans in Southwest Indiana, United States
![](https://www.thieme-connect.de/media/10.1055-s-00041241/201902/lookinside/thumbnails/10-1055-s-0039-3400215_00069-1.jpg)
Abstract
Objective Diabetes is more prevalent among U.S. veterans than the general population. The study is among the U.S. veterans in Southwest Indiana with diabetes mellitus type 2 to understand their demographics, comorbidities, and complications that could help guide strategies to address the prevalence of diabetes among U.S. veterans in the area. Previous diagnosis and referral to the specialty clinics approaches are needed to lower the prevalence of diabetes among U.S. veterans and preventing diabetes-related complications to improve their health status.
Method We constructed a retrospective study of veterans in the Southwest area with medically treated diabetes type 2, who received Veterans Health Administration primary care and were referred to our specialty clinic. We categorized based on demographics, comorbidities, initial HbA1c percentage, and complications, and created multivariable models.
Results In our study of 80 U.S. veterans with diabetes, 90% had comorbidities already when they presented to our clinic. Diabetes was more prevalent in patients older than 60 years. Around 60% of patients presented with complications such as neuropathy, coronary arterial disease, and heart problems. We calculated the HbA1c when the patients came, and around 42% had hemoglobin A1c (HbA1c) over 10%. Patients with exposure to Agent Orange during the Vietnam War had HbA1c over 9%.
Conclusion U.S. veterans with diabetes type 2 referred to the specialty clinic have high HbA1c and more complications on their first visit. Therefore, veterans need to be referred early to the specialty clinics during the course to improve their health status. Mission’s Act 2019 empowers veterans with increased access to community care.
Publikationsverlauf
Eingereicht: 28. August 2019
Angenommen nach Revision: 03. September 2019
Artikel online veröffentlicht:
30. März 2020
© .
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
-
References
- 1 US Census Bureau. Veterans Day. https://www.census.gov/topics/population/veterans/about/veterans-day.html. Accessed October 30, 2017
- 2 US Department of Veterans Affairs. Veterans Health Administration: close to 25 percent of VA patients have diabetes. https://www.va.gov/health/NewsFeatures/20111115a.asp. Updated April 17, 2015. Accessed February 23, 2017
- 3 Miller DR, Safford MM, Pogach LM. Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data. Diabetes Care 2004; 27 Suppl 2 B10-B21
- 4 National Diabetes Statistics Report, 2017: estimate of diabetes and its burden in the United States. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed October 30, 2017
- 5 Veterans Health Administration. Close to 25 percent of VA patients have diabetes. https://www.va.gov/health/NewsFeatures/20111115a.asp. Updated April 17, 2015. Accessed February 23, 2017
- 6 Erin Bagalman. US Congressional Research Service. The number of veterans that use VA health care services: a fact sheet. June 2014. R43579. https://fas.org/sgp/crs/misc/R43579.pdf. Accessed March 10, 2017
- 7 Michalek JE, Pavuk M. Diabetes and cancer in veterans of Operation Ranch Hand after adjustment for calendar period, days of spraying, and time spent in Southeast Asia. J Occup Environ Med 2008; 50 (03) 330-340
- 8 Kang HK, Dalager NA, Needham LL. et al. Health status of Army Chemical Corps Vietnam veterans who sprayed defoliant in Vietnam. Am J Ind Med 2006; 49 (11) 875-884
- 9 Yi SW, Hong JS, Ohrr H, Yi JJ, Yi SW. Agent Orange exposure and disease prevalence in Korean Vietnam veterans: the Korean veterans health study. Environ Res 2014; 133: 56-65