AR 40-501 - California National Guard

Table 5–1Guidance on deployment of Soldiers with diabetesFactor OK to Deploy Should Not Be DeployedHgb A1C (for patient) At target Not at targetMonofilament discrimination Present AbsentAutonomic neuropathy Absent PresentKnowledge of sick day rules Sufficient InsufficientProliferative diabetic retinopathy Absent PresentMacular edema Absent PresentSevere hypoglycemia (an episode requiring anotherperson’s assistance)History of diabetic ketoacidosis in previous 6mos.InfrequentSelf-management skills Good PoorNoFrequentHypoglycemia unawareness Absent PresentParameters of permanent profile can be followedSignificant co-morbidities (for example, congestiveheart failure, chronic kidney disease, significantcoronary artery disease, poorly controlledhypertension) requiring intensive managementRisk of hypoglycemia is high if meals aremissed or delayedDuty will place the Soldier in an OCONUS-Isolatedarea where appropriate medical care andmeans to monitor and support him/her are notavailableYesAbsentNoNoYesNoPresentYesYes(3) Cardiovascular conditions. Review paragraphs 3-21 through 3-24 to determine if an MEB/PEB/trial of duty (orprocessing under paras 9-10 and 10-26 ) is necessary. If the Soldier successfully completes a trial of duty and is foundfit for duty (or returned to duty by a Medical MOS Retention Board (MMRB)), the Soldier should not be deployedwith any of the following conditions—(a) Hypertension not controlled with medication.(b) Recent episodes necessitating emergency room visits or closely monitored follow-up care.(c) Permanent pacemakers, implanted antitachycardia and automatic implantable cardiac defibrillator (AICD) devi c e s , a n d s i m i l a r n e w l y d e v e l o p e d i m p l a n t e d c a r d i a c d e v i c e s r e q u i r e r e g u l a r m o n i t o r i n g f o r b a t t e r y l i f e a n dfunctionality and should not be exposed to high electromagnetic fields. These particular devices have upper extremityphysical limitations.(d) Conditions requiring anticoagulants.(e) Bare metal coronary stents. If the Soldier is found fit for duty by a PEB, the Soldier must remain at a locationwith access to a medical facility with the capability to do an urgent/emergent cardiac catheterization and laboratorymonitoring of anti-platelet therapy for 3 months from the date of stent placement.(f) Drug eluting coronary stents. If the Soldier is found fit for duty by a PEB, the Soldier must remain at a locationwith access to a medical facility with the capability to do an urgent/emergent cardiac catheterization and laboratorymonitoring of anti-platelet therapy for 6 months from the date of stent placement.(g) Closure device for patent foramen ovale or atrial septal defect. If the Soldier is found fit for duty by a PEB, theSoldier must remain at a location with access to a medical facility with echocardiography, cardiology and laboratorymonitoring of anti-platelet therapy capabilities for 6 months from the date of the closure of the defect.(h) Cardiac arrhythmias. If the Soldier has undergone an electrophysiology ablation procedure and the Soldier isfound fit for duty by a PEB, the Soldier must remain at a location with access to cardiac monitoring capabilities for 6months from the date of the ablation procedure.(i) Smallpox vaccine associated myocarditis. If after an evaluation by a cardiovascular specialist, the Soldier isfound to meet medical retention standards, the Soldier must remain at a location with access to echocardiography andmedical monitoring for 6 months from the date myocarditis was diagnosed.(4) Neurological conditions. Review paragraph 3–30 for profile guidance and MEB/PEB processing criteria.(a) Seizure disorders. If the Soldier is controlled with medications and seizure free for one year, the Soldier may beAR 40–501 • 14 December 200761