Type 2 Diabetes Mellitus is a chronic and progressive condition that affects how your body metabolizes sugar (glucose). For many Veterans, Type 2 Diabetes is not just a health concern; it may be directly linked to their military service, particularly for those exposed to Agent Orange. 

This guide explains how to establish a service connection (including the presumptive connection for Agent Orange exposure), the VA’s rating schedule, and the secondary conditions that can arise from diabetes. 

Understanding Type 2 Diabetes and Its Connection to Service 

Type 2 Diabetes occurs when the body either doesn’t produce enough insulin or doesn’t use insulin effectively (insulin resistance). This leads to high blood sugar levels, which over time can damage organs and systems throughout the body. 

For veterans, Type 2 Diabetes can be connected to service through:

Presumptive Service Connection (Agent Orange Exposure)

This is the most common and often the simplest path to service connection for Type 2 Diabetes. The VA recognizes Type 2 Diabetes Mellitus as a presumptive condition for Veterans exposed to Agent Orange or other herbicides during their military service. 

Who Qualifies for Presumptive Service Connection? 

If you served in a qualifying location during specific timeframes and have a current diagnosis of Type 2 Diabetes, the VA will presume your service caused your diabetes. For a presumptive condition, you don’t always need to prove a direct medical link.  

Qualifying service includes: 

• Vietnam War Veterans: Served in the Republic of Vietnam, including inland waterways, or on naval vessels off the coast (“Blue Water” Navy Veterans). 

• Other Agent Orange Exposure Locations: Includes Veterans who served in the Korean Demilitarized Zone (DMZ), Thailand, and other areas where Agent Orange was used. 

If you meet these criteria, you only need to provide proof of your service and a current diagnosis of Type 2 Diabetes. The VA makes the connection for you.

Direct Service Connection

While less common than presumptive connection, direct service connection is possible if: 

• In-Service Onset: Your Service Treatment Records (STRs) show a diagnosis of Type 2 Diabetes or consistent symptoms during your time in service. 

• In-Service Event/Aggravation: You can show a direct link between an in-service event, injury, or other service-connected condition that caused or aggravated your diabetes. 

For more information on Agent Orange exposure and related presumptive conditions, see “Agent Orange Exposure: A Guide to Health Risks and Compensation.”

VA Rating Criteria for Type 2 Diabetes Mellitus (Diagnostic Code 7913) 

The VA rates Type 2 Diabetes Mellitus under Diagnostic Code 7913. The rating is based on the severity of the condition, its management requirements, and the presence of episodes that significantly impact your health. 

Rating Schedule: 

100% Rating: 

• Requires insulin, a restricted diet, and regulation of activities 

• PLUS, experiences episodes of ketoacidosis or hypoglycemic reactions requiring at least three hospitalizations per year, OR weekly visits to a diabetic care provider 

• AND progressive weight loss and loss of strength, OR other complications (neuropathy, retinopathy, etc.) that are not rated separately 

60% Rating: 

• Requires insulin, a restricted diet, and regulation of activities 

• PLUS experiences episodes of ketoacidosis or hypoglycemic reactions requiring at least one or two hospitalizations per year OR two visits per month to a diabetic care provider 

40% Rating: 

• Requires insulin, a restricted diet, and regulation of activities 

20% Rating: 

• Requires insulin and a restricted diet, OR 

• Requires an oral hypoglycemic agent (medication like Metformin) and a restricted diet 

10% Rating: 

• Manageable by restricted diet only 

Key Definitions: 

• Restricted Diet: A specific dietary regimen required to manage blood sugar, often more stringent than general healthy eating guidelines. 

• Regulation of Activities: Avoiding strenuous occupational and recreational activities to prevent blood sugar fluctuations. 

• Ketoacidosis: A serious complication when the body produces high levels of blood acids called ketones. 

• Hypoglycemic Reactions: Episodes of dangerously low blood sugar, severe enough to require intervention or medical attention. 

The Critical Role of Medical Evidence & Documentation 

While your initial rating might reflect your diabetes alone, the true impact is often found in its complications. Documenting each secondary condition thoroughly, with medical records and specialists’ reports, is essential for fair evaluation. 

Common secondary conditions include: 

Diabetic Neuropathy: 

• Peripheral: Numbness or pain in hands and feet 

• Autonomic: Internal organ impact (e.g., gastroparesis, neurogenic bladder, erectile dysfunction) 

Diabetic Retinopathy: 

• Blood vessel damage in the eyes, ranging from mild vision changes to blindness 

Diabetic Nephropathy: 

• Kidney impairment, sometimes leading to dialysis or transplant 

Cardiovascular Conditions: 

• Increased risk for heart disease, stroke, high blood pressure 

Skin Disorders & Amputations: 

• Poor healing, infections, and, in severe cases, the need for amputation 

Erectile Dysfunction: 

• Common among men with diabetes, sometimes qualifying for additional compensation under VA rules 

For more detail on secondary conditions, visit our guide on “Understanding VA Secondary Conditions: A Guide for Veterans.”

Documenting Your Medical Condition: Steps You Can Take 

• Diagnosis: Secure an official diagnosis of Type 2 Diabetes and any secondary health issues from your provider. 
• Medical Records: Gather all relevant medical records (VA and private) including blood sugar logs, test results, medication history, and reports from specialists. 
• Service Documentation: Ensure you have your DD214 and any records confirming your exposure or service in a qualifying location. 
• Symptom Tracking: Maintain a consistent log of your health, noting symptoms and their impact on your life and work. 
• Medical Opinions: For secondary conditions, ask your medical provider for a clear, written opinion (nexus letter) explaining how your service-connected diabetes has contributed to other health problems. 
• Disability Benefits Questionnaire (DBQ): Have your doctor fill out a Diabetes Mellitus DBQ, and DBQs for any additional related conditions. 

Total Disability Individual Unemployability (TDIU) 

If the combined impact of diabetes and its complications means you can’t maintain steady employment, you may be eligible for compensation at the 100% level, even if your rating is technically lower. Speak with your provider and gather all pertinent evidence, as timely documentation is critical. 

For more specific details, see “Is VA Unemployability the Same as 100% Disability? Key Differences Explained.” 

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