To analyze the effects of fasting blood glucose (FBG), fasting insulin (FINS), homeostatic model assessment for insulin resistance index (HOMA-IR) and homocysteine (Hcy) on type 2 diabetes mellitus (T2DM) complicated with ischemic stroke (IS). Methods: We selected 85 patients with T2DM and divided them into the T2DM + IS group (44 cases) and T2DM group (41 cases) according to whether the patient experienced IS. During the same period, 30 healthy volunteers were selected as the control group. The differences in body mass index (BMI), blood pressure, blood glucose, and four indexes of blood lipid among the three groups were compared, and the HOMA-IR was calculated. Multivariate logistic regression was used to analyze the influencing factors of T2DM complicated with IS, and Pearson correlation analysis was used to analyze the relationship between FBG and other indicators. Results: The levels of BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), hemoglobin A1c (HbA1c), FINS, FBG, Hcy, and HOMA-IR in the T2DM group and T2DM+IS group were significantly higher than those in control group, and the level of high density lipoprotein cholesterol (HDL-C) was significantly lower than that in the control group (P<0.05). The levels of SBP, DBP, LDL-C, HbA1c, FINS, FBG, Hcy, and HOMA-IR in the T2DM + IS group were significantly higher than those in the T2DM group (P<0.05). Multivariate logistic regression analysis showed that FINS, FBG, Hcy, and HOMA-IR were the influencing factors of IS in patients with T2DM (P<0.05). Pearson correlation analysis showed that FBG was positively correlated with HbA1c, FINS, Hcy, and HOMA-IR (P<0.01). Conclusion: There is a significant relationship between FBG level and the occurrence of IS in patients with T2DM.