Objective To analyze the changes of IMT, Hcy and urine protein levels in DR patients, and explore the relationship between the three levels and the attack of DR. Methods The study lasted for 3 years(May 2017 to May 2020). 168 patients with type 2 diabetes who had physical examinations in our hospital were set as the study group, and 170 patients who had health examinations in this hospital were the control group. The carotid ultrasound parameters, Hcy and UA levels of patients between the two groups were compared. The number of patients with retinal arteriosclerosis in diabetic patients was counted. Multivariate logistic regression was used to analyze the risk factors of retinal arteriosclerosis in diabetic patients. Results The levels of IMT, Hcy and urine protein in the study group were significantly higher than those in the control group(P＜0.05). In 168 patients with type 2 diabetes, 50 had retinal arteriosclerosis and 118 had no retinal arteriosclerosis. The incidence of DR was 29.76%. The results of univariate analysis showed that there were statistically significant differences between the DR group and the non-DR group in the disease course of type 2 diabetes, triglycerides, glycosylated hemoglobin, IMT, Hcy and urine protein levels(P＜0.05).Abnormal levels of glycosylated hemoglobin, IMT, Hcy and urine protein are independent risk factors that affect retinal arteriosclerosis in diabetic patients(P＜0.05). Conclusion The levels of IMT, Hcy, and urine protein in DR patients are much higher than those of normal people and patients with simple diabetes. The three levels are related to the occurrence and development of DR. In clinic, changes in the patient's condition can be effectively evaluated according to the expression levels.