DED is a common ocular condition, particularly in patients with DM. This narrative review discusses the prevalence and determinants of DED among diabetic patients, focusing on glycemic control, duration of diabetes, and diabetic complications, including neuropathy and retinopathy. The paper also presents pathophysiological mechanisms linking DM and DED and proposes recommendations for clinical management and future research. These findings bring importance of early detection and comprehensive management strategies for improving quality of life in patients with diabetes and DED.