Nationwide Trends and Future Projections of Diabetes and Diabetic Retinopathy Prevalence in Korea: Korean National Health and Nutrition Examination Survey Study

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BACKGROUND: The prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) is expected to increase globally; however, there have been no reports predicting DR prevalence in Korea. This study aimed to estimate the nationwide trend of the prevalence of DM and DR in Korea. METHODS: Diabetic patients aged over 40 were included from the Korean National Health and Nutrition Examination Survey database (2008-2020). The prevalence of DM and DR during the study period was calculated. Four interpolation methods were applied to address the missing DR data (2013-2016), and the method with the smallest error was selected for projection. Holt's linear trend model was used to predict DM and DR prevalence through 2040. We further projected the future number of DR patients in Korea using population projections. RESULTS: We included 8,007 diabetic patients aged 40 years or older and 4,540 individuals with fundus photography results. The prevalence of DM increased from 13.2% in 2008 to 17.3% (4.98 million) in 2020, while the prevalence of DR rose from 16.6% in 2008 to 24.6% (1.23 million) in 2020. The projected prevalence of DM is estimated to reach 19.7% in 2030 and 23.0% in 2040, while DR prevalence is expected to rise to 30.8% (1.97 million) in 2030 and 38.8% (3.15 million) in 2040. CONCLUSION: The prevalence of DM and DR, as well as the number of patients, have increased over 13 years, and this trend is projected to continue through 2040 in Korea. Therefore, it is essential to establish effective healthcare strategies to address this trend.