OBJECTIVES: Cardiovascular (CV) disease is two to four times more prevalent in patients with diabetes than in those without diabetes. This study sought to quantify the impact of CV comorbidities on health care expenditures among patients with diabetes. METHODS: A sample was drawn from 2014 Medical Expenditure Panel Survey (MEPS). Adults aged 18 years or older with self-reported diagnosis of diabetes were included. Individuals with missing data on any study covariates were excluded. Patients were classified as having cardiovascular comorbidity if they reported having ever been diagnosed with any of the following conditions: hypertension, coronary heart disease, angina or angina pectoris, heart attack or myocardial infarction, stroke, or other kind of heart disease. A generalized linear model with gamma distribution and log link were used to assess association between CV comorbidity and healthcare costs among patients with diabetes. The model adjusted for age, gender, race, education, family income, insurance coverage, self-perceived health status and duration of diabetes. The MEPS sampling weights were used to adjust for the complex survey design. RESULTS: A total of 2,022 individuals met study criteria, and 1,656 (81.9%) had one or more CV comorbidities. Patients with CV comorbidity were older than those without CV comorbidity (62.3 years vs. 52.2 years, p<0.001). There was no significant difference in prevalence of cardiovascular comorbidity among males and females (83.6% vs. 80.6%, p=0.091). Non-whites had higher prevalence of CV comorbidity than whites (85.2% vs. 80.0%, p=0.004). The unadjusted cost associated with CV comorbidity was, mean (95% confidence interval, “C.I.”), 7,454 (C.I.=5,541 to 9,366, p<0.001) U.S. dollars (USD) per year. After adjusting for study covariates, estimated cost associated with CV comorbidity decreased to 5,287 (C.I.=2,911 to 7,663, p<0.001) USD per year. CONCLUSIONS: Cardiovascular comorbidity is a significant contributor to healthcare expenditure in patients with diabetes with annual associated cost of 5,287 USD.