Purpose: Among the various manifestations of diabetic eye disease, diabetic retinopathy, a leading cause of preventable blindness, is estimated to impact more than 160 million individuals by 2045. Our objective was to provide an update and investigate the rates of diabetic eye disease by race/ethnicity, sex, socioeconomic status, education, and rurality. Additionally, we aimed to address a gap in research by investigating the rates of diabetic eye disease among the transgender population.

Methods: This study performed a cross-sectional analysis of the 2021 Behavioral Risk Factor Surveillance System to assess disparities in the prevalence of diabetic retinopathy by sociodemographic factors using X2 tests.

Results: The sample included 21,905 participants and found the prevalence of diabetic eye disease was lower in females (17.34%) than males (20.14%), though the highest rate was observed in transgender participants (27.16%; P=.017). White individuals had the lowest prevalence of diabetic eye disease (16.57%) -with all other groups having a prevalence greater than 22% (P<.01). Diabetic eye disease prevalence was inversely associated with income and educational attainment (P<.01). Differences in diabetic eye disease by rurality and insurance status were not statistically significant.

Conclusion: We found higher rates of diabetic eye disease in individuals who identified as Asian, as well as those categorized as "other" within the racial classifications, alongside transgender individuals. While these groups constitute a small proportion of the U.S. population, the observed disparities underscore the importance of heightened surveillance for diabetic eye disease within these demographics. It is essential to prioritize focused interventions aimed at preventing and managing diabetic eye disease among individuals in these groups affected by diabetes.