Abstract: Objective: To explore the related factors of coronary vulnerable plaque in type 2 diabetes (T2DM) and to provide an important basis for clinical prediction and management of coronary vulnerable plaque in patients with T2DM. Methods: A retrospective analysis of 150 patients was performed using T2DM-related clinical indicators and coronary plaque CT angiography (CTA) data, and by the presence of vulnerable plaque groups, to explore the independent risk factors of coronary vulnerable plaque in patients with T2DM and related factors of the ROC curve analysis of its diagnostic efficacy. Results: TG was an independent risk factor for vulnerable plaque in T2DM cases (OR=1.49, 95% CI 1.02~2.18); TIR (OR=0.95, 95% CI 0.92~0.97) and HDL (OR=0.32, 95% CI 0.13~0.78) were independent protection factors. The AUC of TIR, TG, and HDL was 0.71, 0.69, and 0.65, respectively. The AUC for joint prediction was 0.76, 95% CI was 0.68~0.83, sensitivity was 75%, and specificity was 70%. Conclusions: When TIR and HDL decrease and TG increases in patients with T2DM, clinicians should be alert to the possibility of a coronary vulnerable plaque.