Migraine is one of the most common and disabling medical diseases, and it is listed by the World Health Organization as the third most prevalent disease and the second most disabling disease in the world [1,2]. Migraine is more common in middle-aged people (around the age of 40), with a significantly higher prevalence in women than men (35% versus 15%) [3]. The consequences of migraines are widespread, including reduced work efficiency, loss of career potential, and impacts on lifestyle, society, and interpersonal relationships [4]. Migraines can also increase the risk of cardiovascular disease (CVD) and seriously impact personal finances and the quality of life [5].

The 10th edition of the diabetes map report (2021) released by the International Diabetes Federation (IDF) stated that the global incidence rate of diabetes has continued to rise, with 1 in 10 people aged 20–79 having diabetes, confirming that diabetes is a major global challenge to the health and well-being of individuals, families and society [6,7]. Previous observational studies found a link between diabetes and migraines. In a cohort study covering the entire Norwegian population, after 10 years of follow-up (2004–2014), type 1 and type 2 diabetes mellitus (T1DM and T2DM) were found to be significantly associated with a reduced risk of migraine after adjusting for age and gender (risk ratio (RR) = 0.74 [95% CI 0.61;0.89] and 0.86 [0.80;0.92], respectively) [8]. In addition, a prospective cohort study of French women for 24 years (1990–2014) found that in the 24 years before the diagnosis of T2DM, the prevalence of migraine showed a linear downward trend from 22% [16%;27%] to 11% [10%;12%], while in the 22 years after the diagnosis of T2DM, the prevalence of migraine stabilized at about 11% [9]. Both cohort studies based on European populations found that diabetes could significantly reduce the incidence rate of migraine. Nevertheless, other observational studies produced inconsistent conclusions [10], [11], [12], [13], [14].

Compared to other countries, there is a significant need for diagnosis, treatment, and management of patients with migraines in China [15,16]. We found no research on the relationship between T2DM and the incidence rate of migraine in the Chinese population. It is also necessary to identify the clinical characteristics of migraine patients with T2DM. Thus, this study explored the relationship between T2DM and the incidence of migraine based on Chinese population cohort data. A cross-sectional study was conducted to analyze the clinical characteristics of migraine patients with T2DM and explore the impact of T2DM on migraine patients' headache characteristics.