Correct Diabetes Diagnosis and Treatment Allows Sailor to Remain on Active Duty

Abstract

Diabetes is a growing epidemic worldwide and among our active duty population, posing a significant threat to maintaining military health and operational readiness. Latent autoimmune diabetes in adults (LADA) is a growing clinical phenotype of diabetes, with overlap between traditional type 1 diabetes mellitus and type 2 diabetes mellitus. In this case, a 27-year-old active duty male presented with polydipsia, polyuria, polyphagia, and recent weight loss. He was diagnosed with LADA, placed on a period of limited duty status and started on insulin. Eight months after diagnosis, he was transitioned from insulin to a glucagon-like peptide-1 receptor agonist in an effort to be returned to full duty status and worldwide deployable. Over 3 years after initial diagnosis, he has achieved partial clinical remission. He remains on active duty, serving on a medically limited platform with a single medication (a glucagon-like peptide-1 receptor agonist) and high compliance with a gluten-free, low-carbohydrate diet and regular exercise. One should consider the diagnosis of LADA and its unique management, especially in the younger active duty population. Not only is making the correct diagnosis regarding the type of diabetes critical in regard to prognosis and optimal medical management, but it can affect the ability of military members to remain on active duty.