EC Ophthalmology

Diabetic retinopathy, an ocular complication of diabetes mellitus, is the leading cause of blindness in the United States. Effective glycemic control and routine eye screen screening can improve the patients outcomes of those with diabetes. However, due to differences in glycemic control and consistency of screening, diabetic retinopathy disproportionately affects racial and ethnic minority populations. To analyze the extent of these differences, we performed a retrospective patient chart analysis study on 511 patients with diabetes at New England Retina Associates, a vitreo-retinal ophthalmology practice based in Connecticut. We found that of the ethnic groups recorded, on average, Black/African American patients and Hispanic patients presented at the youngest age and had the highest HbA1c. They also had the highest rates of being uninsured or using Medicaid and presenting with a severe form of diabetic retinopathy. Similar healthcare disparities arise when patients are analyzed by insurance type, with patients on no insurance or utilizing Medicaid presenting the worst. As the rate of diabetes in the United States continued to increase, it becomes increasingly important for primary care providers to understand these disparities and incorporate them into their treatments and referrals. We should strive for efforts to improve ocular care for racial minority and socioeconomically disadvantaged patients to reduce healthcare disparities in the treatment of diabetic retinopathy.

Keywords: Diabetic Retinopathy; Diabetes Mellitus; Disparity; Ethnicity; Socioeconomic Status

1. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html
2. Bancks MP., et al. “Association of Modifiable Risk Factors in Young Adulthood With Racial Disparity in Incident Type 2 Diabetes During Middle Adulthood”. Journal of the American Medical Association (2017).