More than a quarter of diabetes patients have diabetic retinopathy, study estimates
Researchers calculated that in 2021, 9.60 million people in the U.S. had diabetic retinopathy, including 1.84 million with vision-threatening diabetic retinopathy, based on data from the National Health and Nutrition Examination Survey and insurance claims, among other sources.
Diabetic retinopathy remains prevalent and may become more so in the coming decades, a study found.
To estimate rates of diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR), researchers used data from the National Health and Nutrition Examination Survey, Medicare fee-for-service claims, commercial insurance claims, population-based studies of adult eye disease, and a previously published analysis of diabetes by county. Data from the CDC's Vision and Eye Health Surveillance System were included to estimate the prevalence of DR and VTDR stratified by age, sex and gender, race and ethnicity, and county and state. Results were published June 15 by JAMA Ophthalmology.
Patients were considered to have diabetes if they had an HbA1c level of 6.5% or more, were taking insulin, or had ever been told that they had diabetes. DR was defined as nonproliferative retinopathy (mild, moderate, or severe), proliferative retinopathy, or macular edema. VTDR included severe nonproliferative retinopathy, proliferative retinopathy, panretinal photocoagulation scars, or macular edema.
The study estimated that in 2021, 9.60 million people in the U.S. (95% uncertainty interval [UI], 7.90 to 11.55 million) had DR, corresponding to a prevalence rate of 26.43% (95% UI, 21.95% to 31.60%) among people with diabetes. It found that approximately 1.84 million people (95% UI, 1.41 to 2.40 million) had VTDR, corresponding to a prevalence rate of 5.06% (95% UI, 3.90% to 6.57%) among people with diabetes. Prevalence of DR and VTDR varied by demographic characteristics and geography. Black and Hispanic patients have a higher standardized prevalence of VTDR (8.66% and 7.14%, respectively) than White patients (3.55%).
The results show that the number of people living with diabetes-related eye disease grew substantially since rates were last estimated in 2004, the authors wrote. They said that updated estimates on the burden and geographic distribution of diabetes-related eye disease can be used to inform the allocation of public health resources and interventions to communities and populations at highest risk.
An invited commentary noted that learning the magnitude of disease prevalence is a first step toward cost-effective prevention. “Timely cost-effectiveness analyses of DR screening programs should be the next step to determine optimal national- and state-level approaches for DR prevention,” the commentary stated. “Efforts for prevention of ocular comorbidities may also be integrated with efforts for primary, secondary, and tertiary prevention of diabetes to most effectively curb the pandemic of diabetes and its sequelae.”