Prevalence of Diabetic Macular Edema
Diabetic macular edema affects approximately 3.8% of individuals with diabetes aged 40 years or older in the United States, translating to roughly 746,000 persons, though global estimates suggest it may affect up to 7% of all people with diabetes worldwide. 1, 2
Overall Prevalence Estimates
The prevalence of diabetic macular edema varies depending on the population studied and methodology:
In the general diabetic population aged 40+ years in the United States, the prevalence is 3.8% (95% CI, 2.7%-4.9%), representing approximately 746,000 individuals based on 2010 population data 1
Globally, diabetic macular edema affects one in 15 people with diabetes, resulting in more than 20 million cases worldwide 3
Broader epidemiological studies suggest DME may affect up to 7% of all people with diabetes, though this higher estimate likely reflects differences in screening methods and population characteristics 2
Type-Specific Prevalence
Type 1 Diabetes
The incidence of diabetic macular edema in Type 1 diabetes is substantially higher than in the general diabetic population:
The 14-year incidence in Type 1 diabetics is 26% according to the Wisconsin Epidemiologic Study of Diabetic Retinopathy 4
The Diabetes Control and Complications Trial reported that 27% of Type 1 diabetic patients develop DME within 9 years of diabetes onset 4
In a 15-year follow-up study, 20.5% of Type 1 diabetic patients developed macular edema, with 11.6% developing focal DME and 8.9% developing diffuse DME 5
Type 2 Diabetes
Type 2 diabetes patients, particularly older individuals, demonstrate an even higher incidence of macular edema compared to Type 1 diabetes patients 4
High-Risk Populations
Non-Hispanic Black individuals face a significantly elevated risk, with 2.64 times higher odds of having DME compared to non-Hispanic whites (OR 2.64; 95% CI, 1.19-5.84) 1
No significant differences in prevalence exist by age or sex in the general diabetic population 1
Key Risk Factors Affecting Prevalence
The following factors substantially increase the likelihood of developing DME:
Elevated HbA1c levels increase odds by 1.47 for each 1% increase (OR 1.47; 95% CI, 1.26-1.71) 1
Diabetes duration ≥10 years increases odds 8.51-fold compared to <10 years duration (OR 8.51; 95% CI, 3.70-19.54) 1
Poor glycemic control (HbA1c >7.5%) significantly increases risk 5
Presence of arterial hypertension 5
High LDL-cholesterol levels 5
Presence of macroangiopathy 5
Severity of underlying diabetic retinopathy 5
Presence of overt nephropathy 5
Clinical Implications
Diabetic macular edema represents the most common form of sight-threatening retinopathy in people with diabetes, making early detection through screening programs critical 3. The prevalence increases substantially with diabetes duration, with two peaks of incidence occurring at 15-20 years and >35 years of diabetes duration 5.