Objective To investigate the correlation between the incidence of type 2 diabetes mellitus (T2DM) with hypertension and the levels of some elements in serum, and to provide a more scientific and reasonable basis for the control of T2DM. Methods A total of 1 024 T2DM patients admitted to a top three hospital in Urumqi from March 2015 to May 2016 were selected. Patients with T2DM were divided into T2DM with hypertension group and T2DM without hypertension group according to the presence or absence of hypertension. Various elements levels in the serum were analyzed. The correlation between serum levels and the incidence of hypertension with T2DM was analyzed, and the related risk factors were explored by using logistic regression. Results Among 1 024 T2DM patients, 627 patients had hypertension, accounting for 61.20%, while 397 patients had no hypertension, accounting for 38.80%. There was a positive correlation between serum sodium and magnesium levels with T2DM in hypertension (P<0.05). The increase of serum sodium level and the decrease of magnesium level were the risk factors of T2DM with hypertension. This result suggested that the difference of serum levels of various elements may play a role in the occurrence and the development of T2DM. Conclusions Serum sodium and magnesium levels were positively correlated with the incidence of T2DM with hypertension. The increase of serum sodium level and the decrease of magnesium level were influencing factors of the incidence of T2DM with hypertension. This study suggests that the serum levels of sodium and magnesium play a role in the occurrence and development of T2DM.