Study: Minorities Experience Diabetic Eye Disease More Frequently

The disparities among racial cohorts were more pronounced in proliferative diabetic retinopathy. Photo: Rami Aboumourad, OD. Click image to enlarge. In a recent study, researchers analyzed 20-year trends between 2000 and 2022 in the prevalence and incidence of diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) among US racial and ethnic groups. They found that racial and ethnic minorities face a disproportionate disease burden, likely influenced by systemic factors such as socioeconomic disparities, poorer access to care, lower rates of screening and worse glycemic control. The findings were reported in Retina.A retrospective cohort study of members of commercial and Medicare Advantage health plans between 2000 and 2022 was conducted, with racial cohorts identified using ICD-9/10 codes. Although the overall incidence and prevalence of VTDR decreased from 2016 through 2021, disparities among groups widened as improvements were not equal. Hispanic patients experienced the most significant worsening of disparities. By 2021, they had the highest odds of having diabetic retinal disease of any group compared to white patients. Black patients consistently showed higher prevalence and incidence rates compared to white patients throughout the study period. Disparities regarding vision-threatening DR and DME remained persistent, while PDR disparities worsened. Asian patients showed smaller, yet significant, increases in the prevalence of VTDR and DME.The most concerning results to the researchers involved PDR rates, which showed the widest disparities. The raw prevalence of PDR among white patients started in 2001 at 3.4% and ended in 2021 at 2.9%. This 15% reduction among the cohort contrasts sharply with 2% reduction in Black populations (started at 4.4%, ended at 4.3%) and 60% increase in Hispanic patients (started at 3%, ended at 5%). “Interestingly, this increase in disparity in PDR prevalence occurred at a time when the PDR incidence decreased dramatically across all groups, just not equally,” the authors wrote in their paper. “This led to the highest incidence rate ratios at the end of the study period.” As long as new cases occur faster for minorities, their disparity will worsen over time, they added.These results also show that having health insurance alone is not sufficient to alleviate disparities, as all patients in the database are included solely because they have health insurance. The Affordable Care Act has worked to reduce the disparity in the uninsured rate among minorities since its inception in 2014. The expansion of insurance coverage to those with lower or lower-middle incomes increases access to care and the ability to better manage their diabetes. The combination of increased screening and improvement in systemic diabetes care may explain the seemingly contradictory increases coinciding with a 10% reduction in vision-threatening DR across all racial and ethnic groups, the authors explained in their paper. “Yet, no minority group reached parity with white patients, implying that addressing systemic barriers to care is crucial to mitigating these ongoing challenges and improving disparities,” they wrote.The study concludes that the widening gaps in disease burden and the faster rate of new cases among minorities will continue to worsen these disparities over time.Click here for the journal source. Goblirsch TJ, Yu Y, Cardillo S, et al. Racial and ethnic differences in prevalence and incidence of diabetic retinal disease. Retina. March 31, 2026. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.