Experiences of patients with insulin‐treated diabetes in conscript military service

Abstract

To determine how young adults with insulin therapy manage daily care of diabetes during the physically demanding conditions of conscript military service, and to evaluate the effects of military service on glycaemic control and on the incidence of acute diabetic complications. An observational study of 47 young male volunteer conscripts receiving insulin therapy was carried out at the Signal Regiment in Riihimäki from January 2001 to July 2005. Outcome measures were drop-out rate from service, management of diabetes care, glycaemic control, and occurrence of severe hypoglycaemia or ketoacidosis during service. Forty (85%) diabetic conscripts completed service, with service time ranging from 180 to 362 days, and seven (15%) interrupted service. One-third of conscripts reported difficulties during military training with insulin injections and blood glucose testing. The mean HbA(1c) during service increased by 0.6% units (P = 0.007) from baseline. Five events of severe hypoglycaemia in three conscripts (overall incidence rate 0.15 per patient-year) and one ketoacidosis event occurred. Diabetic conscripts were chosen for leadership training more often than non-diabetic conscripts. Our data suggest that selected and motivated adolescents on insulin therapy can manage the daily care of diabetes and maintain appropriate glycaemic control during service, although the risk of severe hypoglycaemia exists.