Aims: To investigate the association between glucose and insulin metabolism and migraine, as well as between diabetes mellitus (DM) and migraine, at a Chinese community level. Methods: A community-based, case-control study was performed in Heihe City, China. A survey was conducted door to door by eight trained investigators. Migraine was diagnosed using the International Classification of Headache Disorders (ICHD-III) beta criteria. A total of 2,023 participants completed a questionnaire, underwent a physical examination, and donated fasting blood. After excluding 191 with reported DM, 1,832 participants were included in the study. Of these, 86 participants with migraine and 95 without migraine participated in a 75-g oral glucose tolerance test. Glycosylated hemoglobin (HbA1c) was assessed at 0 minutes and serum glucose and insulin levels were measured at 0, 30, 60, and 120 minutes after glucose loading. Data with skewed distributions were compared using rank sum test, and the associations between DM and migraine were analyzed with logistic regression. Results: There were no significant differences in HbA1c, homeostatic model assessment-insulin resistance (HOMA-IR), β-cell function index of HOMA, or quantitative insulin sensitivity check index (QUICKI) between the participants with migraine and without migraine. When participants without migraine were classified into DM, prediabetes, and normal glucose subgroups and compared with the corresponding migraine subgroups, participants in the migraine subgroup with prediabetes presented higher levels of fasting insulin and HOMA-IR and a lower QUICKI than the nonmigraine subgroup with prediabetes. Moreover, DM was negatively associated with migraine in the 181 subjects who participated in the OGTT; however, no association was found when all 1,832 participants were considered. Conclusion: Insulin resistance seems to exist in individuals with both migraine and prediabetes, and there is a possible negative association between DM and migraine. Keywords: association, diabetes mellitus, insulin resistance, migraine