Robert A. Vigersky, MD

Focus on Prevention

Efforts to keep diabetes rates down among active-duty servicemembers focus on prevention. “Most medical treatment facilities have programs for those with pre-diabetes — soldiers with a very high likelihood of developing diabetes in the next five years — and for those newly diagnosed that help with nutrition, diet, exercise, and general lifestyle changes,” Vigersky said.

In addition, the Diabetes Institute at Walter Reed has 12 studies under way looking for ways for patients and providers to control diabetes. On the provider level, one is evaluating the use of artificial intelligence that applies computer algorithms to better manage patients using blood-sugar levels and other laboratory results, plus current medications.

On the patient side, a study published in Diabetes Care in January reported excellent results for patients who wore a continuous glucose monitor that reports blood-sugar levels every five minutes on a personal digital assistant (PDA)-like device. Study participants who used the device for three months achieved a reduction of about 1% in blood-glucose levels in the first two weeks and sustained that reduction for a year post-study.

Patients “learned what caused sugar to go up and how to better manage it. Now we’re applying the same technology to pre-diabetics so they can see in real time what their blood sugar is doing in response to what they’re doing or eating,” said Vigersky. “This is cutting-edge research, and the benefits will extend far beyond the military.”