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In Alabama, diabetes is ranked 13th for prominent health indicators impacting the state. Out of an estimated state population of 4.9 million, roughly 568,000 (11.6%) Alabamians are affected by diabetes. Furthermore, 9% of the population has been notified of having prediabetes, with approximately 35,700 new diabetes cases in 2022. The medical costs associated with diabetes continue to rise with a concomitant increase in disease incidence and prevalence. Racial health disparities impact African American/Black individuals with diabetes at disproportionate rates. In Alabama, there is a higher prevalence of diabetes among African Americans. Despite current medical interventions, African Americans remain at increased risk for developing complications of diabetes, specifically vision loss and blindness. Nationally, diabetes is the leading cause of new blindness in adults. Vision loss as a complication of diabetes is a growing problem across Alabama as the incidence and prevalence of the disease continue to rise. A staggering 131,000 vision loss cases impact Alabama's health care systems, costing the state an estimated $2.4 million annually. The impact on patients' quality of life is also alarming. In this review, we describe the burden of eye disease due to diabetes in Alabama and examine work being deployed across the state to address managed care barriers to eye health. We highlight the need to focus on health equity by linking community-based advocacy efforts with pharmaceutical industry partners to promote locally based efforts to help reduce the burden of diabetes across the state. [ABSTRACT FROM AUTHOR]