INTRODUCTION: We have recently shown that in the MHS, there are potentially preventable variations with respect to age, sex, and race in the prescriptions of SGLT2i and GLP-1 RA for adults with type 2 diabetes mellitus (DM). In this study we evaluated whether the MHS sector of care—military (direct) vs. civilian (private)—were associated with the variations. METHODS: We extracted data for 2,544,921 non-pregnant adults in 2022. Diagnosis of DM was based on ICD-10 codes, labs, and medications. We defined adults as belonging to the direct, private, or mixed sector of care. We used multivariable logistic regression to calculate odds ratios for medication use, adjusting for demographics, socioeconomic status, and comorbidities. We then analyzed the interaction of sectors with sex, race, and ethnicity. RESULTS: In 2022, 159,336 (6.3%) adults had DM (median [IQR] age 60 [54–64]). DM prescription rates for SGLT2i and GLP-1 RA were 26.4% and 26.7%, respectively. By sector, 32.8% were direct, 30.7% were private, and 36.5% were mixed. The adjusted odds for overall SGLT2i use were lower in the private and mixed sectors compared to direct care, while the adjusted odds for overall GLP-1 RA use were higher in private vs. direct care (p<.05). SGLT2i use was higher in males and was lower in adults of Asian American or Pacific Islander (AA/PI), Black, and Other race compared to reference adults of White race (p<.05). Overall use of GLP-1 RA was higher in Hispanic adults, and lower in males and adults of AA/PI, Black, Other, and Unknown race (p<.05). The interaction terms showed higher odds of SGLT2i prescription to Black adults in the private and mixed sectors of care vs. direct care. The interactions terms also showed that GLP-1 RA was more likely to be prescribed to AA/PI and Black adults in the private and mixed sectors care and was also more likely to be prescribed to adults with Junior Officer sponsor in the mixed sector and Senior Officer sponsor in the private sector (p<.05). GLP-1 RA was less likely to be prescribed to males in both private and mixed sectors and to adults with Junior Enlisted sponsors in the private sector (p<.05). CONCLUSION: This study identified potentially preventable variations based on sex, race, and rank in the use of SGLT2i and GLP-1 RA across MHS sectors of care. Further investigation is necessary to determine the factors underlying these variations and strategies to address them. The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views, assertions, opinions or policies of the Uniformed Services University of the Health Sciences (USUHS), the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., or the Department of War.