Aim To investigate the relationship between serum total bilirubin (TBIL), glycated albumin (GA), hemoglobin A1c (HbA1c) and diabetic vascular complications. Methods 176 diabetic patients hospitalized in our hospital from August 2017 to May 2018 were divided into vascular disease group and non-vascular disease group according to whether there were vascular complications. Biochemical indexes such as TBIL, GA and HbA1c were measured. Logistic binary regression was used to analyze the influencing factors of vascular complications in patients with diabetes mellitus. Results 120 cases were eventually included in vascular disease group and 56 cases in the non-vascular disease group. There was no significant difference in gender, age and body mass index (BMI) between the two groups (P>0.05). Compared with non-vascular disease group, vascular disease group had longer course of disease, lower values of total cholesterol (TC), high density lipoprotein cholesterol (HDLC) and TBIL, higher values of GA, HbA1c, triglyceride (TG) and low density lipoprotein cholesterol (LDLC), the difference was statistically significant (P<0.05). Further binary logistic regression analysis showed that high HbA1c level, low TBIL level and long course of disease were independent risk factors for diabetic vascular complications (P<0.05). Conclusion The screening of vascular diseases and active intervention should be paid to avoid the occurrence of serious complications.