OBJECTIVES:  The incidence of type 2 diabetes (T2D) in patients with lung cancer (LC) may vary from that of the general population, as there is a likely association with hyperinsulinemia, which is a result of insulin resistance characteristic of T2D. Insulin's role in cell proliferation, through the action of insulin-like growth factor-1, could play a significant role in the development of cancerous tissues. Our objective is to characterize healthcare utilization and associated hospitalization costs in LC patients with diabetes. METHODS:  We conducted a cross-sectional study of LC patients (ICD-9 162.xx) from the 2012 Nationwide Inpatient Sample. A prevalence estimate for T2D patients with LC was established using the discharge weight that was included in the NIS for each observation; however, all other analysis did not include the discharge weight. We compared patients with diabetes (ICD-9 250.xx) to those without on length of stay (LOS) and total cost using chi-square test of association. Finally, we assessed factors predicting increased LOS and inpatient mortality using logistic regression. RESULTS:  We estimated US prevalence of inpatients with a diagnosis of LC and diabetes at 91,240 cases. LC diabetic patients were older, with an average age of 70.27vs.68.47 years(p<0.001) compared to their non-diabetic LC-peers. Hospitalizations associated with diabetic LC patients were associated with a significantly longer LOS 6.31vs.6.11 days(P<0.001), compared to non-diabetic patients. Significant positive predictors of increased LOS among diabetic LC patients included visiting a hospital in a rural location (Odds Ratio(OR)=1.20, 95%Confidence Interval=1.11-1.31) and Private Insurance (OR=1.25 95%CI=1.04-1.50). Significant positive predictors of inpatient mortality included Medicare (OR=2.52 95%CI=1.81-3.5), Medicaid (OR=2.01 95%CI=1.37-2.97), and hypertension as a comorbidity (OR=1.32 95%CI=1.18-1.48). CONCLUSIONS:  These data suggest that LC patients with diabetes have extended hospitalizations compared to those without diabetes. Clinical strategies to better manage diabetes in LC patients could enhance metabolic health, reduce hospitalization time, and lower healthcare costs.