OBJECTIVES: Although hypertension and obesity are common comorbidities among patients with type 2 diabetes (T2D), their prevalence and burden has often not been explored outside the US. The objective of the current study was to assess the incremental effect of each comorbidity in isolation and in combination among T2D patients in Japan. METHODS: Data from the 2010 Japan National Health and Wellness Survey (NHWS) were used in the analysis. The NHWS is an Internet-based self-reported survey administered to the adult population of Japan (N=25,000).  Respondents who reported a diagnosis of T2D and provided weight information were included in the analysis; they were subsequently categorized based on their comorbidities: T2D+obesity only, T2D+hypertension only, T2D+obesity+hypertension, or T2D without either obesity or hypertension.  Groups were compared on health status (using the SF-12v2) and self-reported healthcare resource use in the past six months through regression modeling controlling for demographics, health behaviors, and comorbidities.  RESULTS: Of the 957 patients who reported a diagnosis of T2D, most reported neither an obesity nor hypertension comorbidity (n=506; 52.87%). 255 (26.65%) patients reported T2D+hypertension, 98 (10.24%) reported T2D+obesity, and 98 (10.24%) reported both T2D+hypertension+obesity. Adjusting for demographics, health behaviors, and comorbidities, patients with T2D+obesity (Mean=43.42), T2D+hypertension (Mean=46.51), and T2D+obesity+hypertension (Mean=44.03) all reported significantly worse physical component summary scores than those with only T2D (Mean=47.76) (p<.05). Similar, though slightly weaker, differences were observed with respect to health utilities. All comorbidity groups also reported significantly more physician visits (T2D+obesity=14.25; T2D+hypertension=12.06; T2D+hypertension+obesity=15.37) in the past six months compared with those with only T2D (9.94; all ps<.05). CONCLUSIONS: Although most patients in Japan with T2D do not have concomitant hypertension or obesity, those that do report a significant health status and direct cost burden. Improved management of these comorbidities could result in a substantial societal benefit.