Evidence-based articles have demonstrated an increase in diabetes prevalence, but diabetes prevalence in the enrolled Military Health System population was previously understudied. Variability in diabetes prevalence rates calculated from 5 groups of algorithms was examined in the Military Health System population (3 million enrollees per year) from fiscal years 2006 to 2010. Time trend analysis and rate comparisons to the U.S. population were also performed. Increasing linear trends in diabetes prevalence from 2006 to 2010 were seen in all algorithms, though considerable rate variation was observed within each study year. Prevalence increased with age, except for a slight decrease in those ³75 years. Overall diagnosed diabetes prevalence ranged from 7.26% to 11.22% in 2006 and from 8.29% to 13.55% in 2010. Prevalence among active duty members remained stable, but a significant upward trend was observed among nonactive duty members across study years. Age-standardized rates among nonactive duty females were higher than the U.S. population rates from 2006 to 2010. This study demonstrates prevalence rate variability because of differing case algorithms and shows evidence of a growing diabetes population in the Military Health System, specifically within the nonactive duty 45 years and older demographic groups. Further research of this population should focus on validation of case definitions. INTRODUCTION Diabetes, both type I and type II, is a chronic and disabling disease that has far-reaching health consequences in terms of short-and long-term complications. The 2005 to 2008 National Health and Nutrition Examination Survey estimated diabetes prevalence in the United States for adults 20 years of age or older to be 11.3%. 1 Boyle et al 2 estimated prevalence would increase up to 30% by 2050. Globally, estimates show prevalence could increase nearly 70% in developing countries and 20% in developed countries in the next 20 years. 3 This is a daunting trend given that the estimated cost of diagnosed diabetes in the United States in 2012 was $245 billion, includ-ing $176 billion in direct medical costs and $69 billion in reduced productivity. 4 Huang et al 5 projected the cost of caring for an increasing diabetic population will double in the next 25 years. Without effective prevention, intervention, and dis-ease management strategies, health care resource utilization by the growing diabetes population will impose a heavy burden on health care systems.
Chao, S. Y., Zarzabal, L. A., Walker, S. M., Herzog, C. M., Eilerman, P. A., Luce, B. K., & Carnahan, D. H. (2013). Estimating Diabetes Prevalence in the Military Health System Population From 2006 to 2010. Military Medicine, 178(9), 986–993. https://doi.org/10.7205/milmed-d-13-00147