Agent
Orange and type 2 diabetes
Vietnam
veterans with type 2 diabetes are eligible for disability
compensation from the Department
of Veterans Affairs (VA) based on their presumed
exposure to Agent Orange or other herbicides. In 2000, the
VA added type 2 diabetes to the list of "presumptive
diseases associated with herbicide exposure." That
action followed a report from the National Academy of
Sciences that found "limited/suggestive" evidence
of an association between the chemicals used in herbicides
during the Vietnam War, such as Agent Orange, and type 2
diabetes.
The
evidence of a link between exposure to Agent Orange (or
dioxin, the problematic contaminant in Agent Orange) and
diabetes is modest. Most of the association between Agent
Orange and diabetes comes from studies of people who lived
near or worked at manufacturing plants that produced large
quantities of Agent Orange dioxin. In those cases, there
appears to be some relationship between Agent Orange
exposure and increased insulin resistance, the precursor to
type 2 diabetes. In general the exposure that Vietnam
veterans had to Agent Orange was much less than in the
populations studied by scientists. Still, the VA has added
diabetes to the list of conditions for which Vietnam
veterans are eligible for disability compensation.
What
is Agent Orange and what is dioxin?
Agent
Orange was a herbicide used in Vietnam to kill unwanted
plants and to remove leaves from trees which otherwise
provided cover for the enemy. In the 1970s some veterans
became concerned that exposure to Agent Orange might cause
delayed health effects. The concern about Agent Orange
focuses not on the active ingredient, an herbicide with
little or no effect on animals, but on a trace contaminant
in the herbicide, dioxin. Studies have shown that dioxin and
dioxin-like compounds (DLCs) can cause a variety of
illnesses in laboratory animals. More recent studies have
suggested that the chemical may be related to a number of
types of cancer and other disorders.
In
1978, the Veterans Administration set up the Agent Orange
Registry health examination program for Vietnam veterans who
were concerned about the possible long-term medical effects
of exposure to Agent Orange. Vietnam veterans who are
interested in participating in this Agent Orange program
should contact the nearest
VA medical center for an examination.
Veterans
who participate in the Agent Orange examination program are
asked a series of questions about their possible exposure to
herbicides or Agent Orange in Vietnam. A medical history is
taken, a physical examination is performed, and there is a
series of basic laboratory tests. If medically required,
consultations with other health specialists are scheduled.
However, no special Agent Orange tests are offered since
there is no test to show if any individual veteran's medical
problem was caused by Agent Orange or other herbicides used
in Vietnam. There are tests that show body dioxin levels,
but such tests are not done by the VA because there is a
serious question about their value to veterans. The VA
simply makes a presumption of Agent Orange exposure for
Vietnam veterans.
In
its 1994 report on Agent Orange, the National Academy of
Sciences (NAS) concluded that individual dioxin levels in
Vietnam veterans are usually not meaningful because of
background exposures to dioxin, poorly understood variations
among individuals in dioxin metabolism, relatively large
measurement errors, and exposure to herbicides that did not
contain dioxin.
Benefits
of the Agent Orange examination
The
veteran is informed of the results of the Agent Orange
examination during a personal interview and gets a follow-up
letter further describing the findings. Each veteran is
given the opportunity to ask for an explanation and advice.
Where medically necessary, a follow-up examination or
additional laboratory tests are scheduled. The examination
and tests sometime reveal previously undetected medical
problems. These discoveries permit veterans to get prompt
treatment for their illnesses. Some veterans feel they are
in good health, but are worried that exposure to Agent
Orange and other substances may have caused some hidden
illness. The knowledge that a complete medical examination
does not show any problems can be reassuring or helpful to
Registry participants. All examination and test results are
kept in the veteran's permanent medical record. These data
are entered into the VA Agent Orange Registry.
Vietnam
veterans can get medical treatment for Agent Orange-related
illnesses. Under Section 102, Public Law 104-262, the
Veterans' Health Care Eligibility Reform Act of 1996, the VA
shall furnish hospital care and medical services, and may
furnish nursing home care to veterans exposed to herbicides
in Vietnam. There are some restrictions. The VA cannot
provide such care for a 1) disability which VA determines
did not result from exposure to Agent Orange, or 2) disease
which the NAS has determined that there is
"limited/suggestive" evidence of no
association between occurrence of the disease and exposure
to a herbicide agent.
The
VA pays disability compensation to Vietnam veterans with
injuries or illnesses incurred in or aggravated by their
military service. Veterans do not have to prove that Agent
Orange caused their medical problems to be eligible for
compensation. Rather, the VA must determine that the
disability is "service-connected." A Veterans
Services Representative, at a VA medical center or regional
office, can explain the compensation program in greater
detail and assist veterans who need help in applying. For
more information about the VA's Agent Orange Program, call
the toll-free helpline 1-800-749-8387. For disability
compensation program information, call toll-free
1-800-827-1000.
Web
Resources
The
Vietnam
Veterans of America Association provides a guide is to
assist you, the veteran or survivor, in presenting your
claim based on the veteran's exposure to herbicides in
Vietnam in the best way possible to the U.S. Department of
Veterans Affairs.
The
National
Veterans Legal Services Program provides legal services
to veterans on matters relating to their service and has
further information on the VA's benefits regarding Agent
Orange on their website.
Additional
information on how the VA is handling Agent Orange claims
can be found at http://www.va.gov/agentorange.
The
National Academy of Sciences report on Agent Orange and
diabetes can be found at http://www.nap.edu/catalog/9982.html.
FROM
- AMERICAN DIABETES
ASSOCIATION