Diabetes mellitus (DM) is currently one of the most prevalent chronic diseases in the United States. It is estimated that 12.3% of Americans suffer from DM. In this study the authors compare between dry eye and diabetes mellitus among a large North Carolina patient population. A total of 81,480 patients were included in the analysis; of those, 8978 patients had dry eye and 18,480 patients had diabetes. The results show a significant association between dry eye disease (DED) and diabetes. When adjusting for patient gender, age group, race and ethnicity, the odds of having dry eye disease are 1.15 times larger for a patient with diabetes as compared to a patient without diabetes. In addition, the study shows that the association between DM and DED varies greatly based on race and ethnicity. While all racial / ethnic groups with diabetes showed increased odds of DED diagnosis, only White and Asian patient populations were found to be statistically significant. Blacks and Hispanics were both found to have the smallest and non-significant odds and the findings contrast the racial predilection of other reported ocular and microvascular diabetes complications.