Trends and Racial/Ethnic Disparities in Diabetic Retinopathy Among Adults with Diagnosed Diabetes in North Carolina, 2000-2015.

BACKGROUND There is limited information available in North Carolina on the current burden of, and racial disparities in, diabetic retinopathy (DR), a major complication associated with diabetes mellitus (DM). This study aims to describe the overall trend of, and racial/ethnic disparities in, DR among adults with DM in North Carolina. METHODS Data were from 13 waves (2000, 2002-2010, 2012, 2013, and 2015) of the Behavioral Risk Factor Surveillance System. The study sample included 16,976 adults aged ≥ 40 years with DM in North Carolina. DR was identified by self-report by the question, "Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?" The overall prevalence of DR was assessed during the time period, and was compared between whites and blacks. All analyses were conducted using Stata 13.0. RESULTS The prevalence of self-reported DR in North Carolina decreased from 27.2% in 2000 to 18.3% in 2015, a reduction of 33% (Trend P = .003). The age-adjusted DR prevalence in whites decreased from 21.7% to 17.6% (Trend P = .04), and in blacks from 39.4% to 20.2% (Trend P = .002). The declining rates in DR were not statistically different between whites and blacks ( P = .06). Blacks were more likely to report DR (adjusted odds ratio = 1.20, 95% confidence interval, 1.03-1.40) during 2000-2015. CONCLUSION The prevalence of self-reported DR in adults with DM declined significantly in North Carolina in the past 15 years. While racial differences in some years appeared to be decreasing, the black-white disparity in DR prevalence during the entire period persisted. Focused efforts on reducing the gap are needed.