Diabetic Retinal Disease Rates Narrow by Diabetes Type

US claims data showed rising prevalence of diabetic retinal disease in type 1 and type 2 diabetes, while incidence declined in type 1 diabetes and moved closer to type 2 rates by 2022.

By
Andrea Surnit
April 15, 2026
5 min

Conexiant

Overview

Between 2016 and 2021, the prevalence of diabetic retinal disease (DRD) increased in both type 1 and type 2 diabetes patients, while overall incidence declined in type 1 diabetes and approached rates seen in type 2 diabetes by 2022. Despite this convergence in overall incidence, vision-threatening diabetic retinal disease (VTDR) and its subtypes remained consistently more common in type 1 diabetes.

Background

Diabetic retinal disease is a common microvascular complication of diabetes, leading to vision impairment and blindness. It encompasses conditions such as diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR), which are more severe forms. Understanding trends in prevalence and incidence by diabetes type is critical for guiding screening and management strategies. This study analyzed a large US administrative claims database to assess these trends over several years.

Data Highlights

Measure	Type 1 Diabetes 2016	Type 1 Diabetes 2021	Type 2 Diabetes 2016	Type 2 Diabetes 2021
DRD Prevalence	25%	34%	11%	21%
VTDR Prevalence	12%	17%	4%	6%
DME Prevalence	5%	8%	2%	4%
PDR Prevalence	9%	13%	2%	3%
DRD Incidence (per 1,000 person-years)	55.1 (2016)	39.2 (2022)	31.6-38.5 (2016-2022)	35.5 (2022)
VTDR Incidence (per 1,000 person-years)	23.3 (2016)	14.5 (2022)	11.0 (2016)	6.6 (2022)
DME Incidence (per 1,000 person-years)	17.8 (2016)	10.0 (2022)	8.7 (2016)	5.4 (2022)
PDR Incidence (per 1,000 person-years)	12.1 (2016)	9.3 (2022)	4.6 (2016)	2.7 (2022)

Key Findings

Prevalence of diabetic retinal disease increased steadily from 2016 to 2021 in both type 1 (25% to 34%) and type 2 diabetes (11% to 21%).
Overall DRD incidence declined in type 1 diabetes from 55.1 to 39.2 cases per 1,000 person-years between 2016 and 2022, while incidence in type 2 diabetes remained relatively stable, narrowing the incidence gap.
Vision-threatening diabetic retinal disease (VTDR) and its subtypes (DME and PDR) had consistently higher prevalence and incidence in type 1 diabetes compared to type 2 diabetes throughout the study period.
Incidence rate ratio for overall DRD between type 1 and type 2 diabetes decreased from 2.00 in 2016 to 1.43 in 2022, indicating convergence in overall incidence rates.
Despite overall incidence decline, the disparity in PDR incidence between diabetes types widened over time.
Increasing prevalence may reflect a growing diabetic population and longer survival, while declining incidence in type 1 diabetes may be due to advances in diabetes care.

Clinical Implications

Clinicians should recognize that patients with type 1 diabetes continue to bear a higher burden of diabetic retinal disease, particularly severe forms such as VTDR, DME, and PDR. The narrowing incidence gap suggests improvements in management, but ongoing vigilant screening and timely intervention remain essential, especially for type 1 diabetes patients. Awareness of these trends can inform resource allocation and patient counseling.

Conclusion

While overall diabetic retinal disease incidence is declining and converging between diabetes types, type 1 diabetes patients maintain a higher prevalence and incidence of vision-threatening complications. Continued efforts in prevention and early detection are warranted to address this persistent disparity.