Leaving the active-duty military for the civilian world can stir up feelings of confusion, alienation and irritability among service members — a circumstance so common it has its own name: “transition stress.”
For service members with diabetes, exiting the military is particularly challenging. The transition often makes troops’ diabetes symptoms worse, according to a study published in Military Med.
Transition stress and the relationship to diabetes
Many service members feel as if they’re losing structure and purpose when leaving the military. James Wilson, M.D., who served as a doctor in the Navy and Marine Corps, observed those complications firsthand.
“I spent a fair amount of time helping service members transition out. I got them their outro-physical and made sure that they were set up for success,” said Wilson, who is now a critical care physician at Northwest Community Hospital in Chicago.
The transition stress that service members feel when leaving the military has the potential to worsen diabetes symptoms. Stress, anxiety or depression can also cause complications, such as weight gain, that could worsen diabetes symptoms or even trigger new-onset diabetes.
Stress has a significant effect on metabolic function and can cause blood-sugar levels to rise because of the hormones being released in a stress response.
“If you’re under constant stress, blood sugar and cholesterol can be bad because these hormones are trying to pump your body with a continuous energy supply,” Wilson said. “And then, the habits you tend to have when depressed are anxious — not eating, eating too much, smoking, whatever it may be — can hurt.”
Read: Are You at Risk of Developing Diabetes? >>
Taking responsibility of your care
Managing diabetes requires lifestyle changes, which includes regular visits with medical providers. People diagnosed with this chronic condition need to see a primary care physician on a regular basis and meet with endocrinologists — doctors who specialize in the treatment of hormone-related conditions, who can help them manage their blood sugar levels.
Because of the potential for diabetes to cause diabetic retinopathy (damage to the blood vessels in the eyes) or diabetic neuropathy (nerve damage) or poor blood flow to the feet, increasing the risk of eye and foot complications, people with diabetes also need to visit optometrists and podiatrists annually, if not more frequently.
“The military has a great amount of money invested in a service member’s development,” said Wilson. “Outside of the military, a doctor isn’t going to be calling you every day, three times a day, asking you to log your blood sugar. So, that has to become a lifestyle change, and it’s easy to let slip.”
Another factor transitioning service members must consider is exercise. Physical activity helps keep blood sugar in a normal range. People with diabetes are encouraged to do at least 30 minutes of moderate-intensity activity every day, in addition to walks after every meal to prevent blood sugar spikes.
The military requires physical fitness tests on a regular basis. The frequency of those tests vary by service branch, but they all typically include timed runs, pushups, situps and power throws. Maintaining that type of activity after leaving the military can help people with diabetes manage the condition, Wilson said. Service members with diabetes lose the regimented fitness schedules that help lessen their symptoms when they leave the military.
Resources that can help
Before leaving service, troops with diabetes should share their family health histories with their military doctors to better understand the risks of the condition, Wilson advised. He also suggested service members ask questions in their appointments about how to manage their symptoms.
As service members transition out, they’re required to go through the Transition Assistance Program, or TAP, which provides training for troops who are preparing for the next phases of their lives. The program starts with an individualized counseling session between service members and a TAP counselor, during which troops begin to develop their own transition plans.
The course includes information about transitioning from military-provided healthcare to healthcare provided by private doctors or the Department of Veterans Affairs. TAP counselors take service members through a one-day briefing about the VA and the benefits the agency can provide them. If veterans with diabetes are enrolling in the VA, they can use resources like the VA’s Diabetes Self-Management Education and Support (DSMES) program.
TAP counselors will continue to help veterans for up to 180 days after they’ve separated from the military. New veterans and their spouses can reach out for one-on-one support, referrals or other assistance during that time frame.
This educational resource was created with support from AstraZeneca.
