Background: Type 2 diabetes is a major lifestyle disease often seen with comorbidities or complications. This study is conducted to find out the gender-wise prevalence of comorbidities and medication adherence among the diabetics in Malappuram. Methods: A cross-sectional study was conducted among the 179 diabetics selected for the study. A pre-tested interview schedule was used to collect information about their socio-demographic details, clinical characteristics, co-morbidities and awareness on complications. Anthropometric measurements and blood pressure of each patient were recorded. Body Mass Index, Waist Hip Ratio and Household Dietary Diversity Score were calculated. The results were analyzed statistically. Results: The selected diabetics comprised of 46.4% males and 53.6% females. Around 91% of them were sedentary workers. Early-onset of diabetes at the age of 35-45 years was reported among males (p<0.05). Blood sugar monitoring, insulin usage, and exercise were higher among males while the medication regularity was higher among females. Higher prevalence of obesity (62.5%), hypertension (53.1%) and hypercholesterolemia (59.5%) were observed among the female diabetics. The prevalence of retinopathy (15.7%) and heart diseases (13.3%) were higher among the males. 76 percent of diabetics had poor awareness of complications of diabetes in which females outnumbered males (p<0.01). Conclusion: High prevalence of comorbidities and lack of awareness on complications emphasizes the necessity of mass and individual counseling on diabetes and its self-care measures to the diabetics. INTRODUCTION: Type 2 diabetes is an alarming global epidemic increasing due to population growth, aging and obesity. In 2017, the prevalence of diabetes among men and women was 8.9% and 8.4% respectively 1. It is the seventh leading cause of death, and along with obesity and hypertension, it leads to heart diseases, which are the first leading cause of death in the world 2 .