The young diabetic subjects in the Israel Army

Between 1978 to 1986, 145 of the Type 1 diabetic patients under our care reached the age of 18 (military service recruitment age). Of the 77 (45 men, 32 women) who decided to volunteer for service, 60 (35 men, 25 women) responded to a questionnaire relating to the conditions of their military service following its completion-these comprised Group A. Of the 68 patients who did not volunteer for service (20 men, 48 women), 44 patients comprised Group B (10 men, 34 women). Group A and Group B were compared in regard to their diabetes history and diabetes management and control during two periods, 17-18 years and 18-20 years. Group A was also evaluated regarding military employment, working and accommodation conditions and diabetes management during army service. The patients in Group A came from a higher socioeconomic level (p < 0.009) and had a significantly higher educational level (p < 0.008). The men in Group A achieved significantly better diabetes control, as evaluated by HbA1, in both periods compared to all the others in both groups. During army service the patients in Group A underwent fewer hospitalizations than the others and only two of them developed complications, whereas among those in Group B 5 patients developed complications. Our data demonstrate that youngsters with Type 1 diabetes can maintain satisfactory diabetes management and control and can function not only adequately, but often far beyond, in the stressful situations with which they are confronted within the rigid authoritative system of military service. Our data also indicated that diabetic patients wishing to volunteer for such service constitute a selected group with a higher socioeconomic background and a higher motivation to prove themselves.