Diabetes and the military

I came across this article on Facebook and thought I would share. This young man was diagnosed with Type1 and fought to be commissioned to the Military - and won!

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I am a retired Lt Col, former Squadron Commander twice over, deployed to multiple conflict zones. I’m also a T1D LADA. It would have been unfair for me, and more so to those with whom I served, with the risks and requirements I have as a T1D. I’m fairly certain Lt Johnson’s role will be limited to non- or minimally deployable and carefully chosen career fields or assignments that have no or very limited exposure to conflict environs…whether disclosed or not by the USAF…and it is done for good reason and necessity. While I believe people with diabetes can perform multiple roles for the current military, the great majority of those roles have been or will be civilianized, because most don’t require a uniformed presence. The military simply cannot allow an unlimited number of diabetics, or any other medical condition with similar requirements, in it’s ranks. Our military is tasked with fighting the nations conflicts and the environments in which that is done cannot be encumbered by a requirement for medications essential to life available at all times. The current requirement for insulin and medical devices to deliver it are incompatible with most deployed military environments. Could it be done, absolutely; should it be done, resoundingly NO! Many deployable environments are incompatible with insulin, CGMs, AIDS, etc. They and people with them would present risks to themselves, but more so to the teams of which they are essential members. As if this isn’t enough, there is also the consideration of supply lines of medical supplies currently essential for a diabetic’s survival in a world where needed and essentail war fighting equipment often gets delayed enroute and in less than ideal environments. Any position that doesn’t require the capability to be deployed to these environment has, can, or probably will be converted to a civilian role, specialized though it may. Of course, exceptions can and will exist, but I suggest the great majority of positions in which a T1D could adequately serve is one ripe for being civilianized. And there’s nothing wrong with being a civilian, I’m proud to have served in both roles and contributed to our country equally in both. I’m sure Lt Johnson will too. Perhaps when the equipment and medicines are more ruggedized it will be possible for a change to occur, but that time is not now.

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Thank you for expounding on the article. While I was pleased about the work he did to be accepted I did wonder about the practicality of active duty service. Perhaps I missed something in the article but I don’t think that was made clear. Thank you again for clarifying, and for your service.

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Dorie,
Thanks for understanding the view point, I was concerned it might come off as unfeeling or crass. I feel for Lt Johnson’s situation; I know the Academy takes a significant level of demanding and uncompromising effort most people wouldn’t endure. Having it snatched away by T1D after 4 years of effort would be particularly cruel. But having commanded troops…and Lt Johnson may learn this…sending them in harm’s way, serving with them there, is a large enough responsibility without adding additional non-essential risk to their lives and possible critical mission failure. Even sitting behind a desk or console…possibly directing satellite ops supporting a critical field operation?…when a T1 low hits and the person isn’t at the top of their game is an unacceptable additional risk. It may sound melodramatic. It might not happen. It certainly isn’t fair. It just is.

Tom

Not a problem, @Tlholz . I actually admire people who tell it like it is. I need to lean that way more myself sometimes.

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He could certainly serve in other ways such as law enforcement and even being a fire fighter. I’ve met an Orange County Sheriff, an Irvine police officer and an LA County Firefighter that are wearing pumps and living their dream.

Thank you to the OP for this truly interesting story, and to you for sharing your perspective. It’s really quite fascinating.

I was diagnosed with T1D in 1986 when I was 12 years old, and one of the first things I remember my father telling me was “at least now you can’t be drafted into the military.” (Remember that 1986 was not long after the Vietnam war. My father was a teacher and was therefore ineligible to be drafted. He followed in my grandmother’s footsteps, though I’ve never been sure if he did that in order to avoid being drafted.)

Though I’ve never considered a career in the military, I have traveled quite a bit to countries with unreliable infrastructure. I spent about a year and a half backpacking through Asia, and had to bring all of my insulin with me in Frio insulated gel pouches. When we had a room with a small fridge, I would put my insulin in there to “recharge”. I got lucky-- at the time I didn’t realize how unreliable those small refrigerators are, but they never failed or froze my insulin thank goodness.

Within a week of arriving in SE Asia, my insulin pump began to fail (likely because it sat next to the magnetic compass in my pocket. Then because we were outside all day in the sweltering heat, the insulin in my pump cooked and failed. Thankfully, I had thought to bring a Frio pouch that could hold my pump on my belt, insulating it from the extreme temperatures.

I can’t imagine having to deal with these kind of logistical details while deployed in a combat zone. I agree that worrying about whether your body has too much or too little insulin, or whether that insulin is failing, or whether the pump cannula is failing, or whether you have a bad absorption site, cannot be on your mind when you and your colleagues lives are on the line.

I fully agree with the FAA’s decision to allow diabetics to become commercial pilots because those same extreme conditions do not exist in the cockpit of a commercial airliner. It’s much easier to anticipate and overcome any potential problems. The climate is controlled, and with CGM alerts very few blood sugar problems can now surprise you out of the blue. And in extreme cases, there’s a co-pilot to cover you while you change out your pod, drink some OJ or give yourself a bolus injection. But were I in a war zone? All of that goes out the window.