Objective To explore the therapeutic efficacy of ultrasound-guided central venous catheterization in patients with diabetes mellitus and gastric cancer and its influence on the expressions of adipokines and insulin-like growth factors-1 (IGF-1).Methods A total of 150 patients with diabetes and gastric cancer who were treated in our hospital from January 2018 to June 2019 were selected, and all patients were randomly divided into a direct vein puncture group and an ultrasound-guided group, each with 75 cases. Enzyme-linked immunosorbent assay was used to detect the levels of resistin, leptin and adiponectin. Flow cytometry was used to detect the levels of insulin-like growth factor receptor 1 (IGFR-1), phosphatase and tensin homolog deleted on chromosome 10 (PTEN), and IGF-1 in the peripheral blood. The success rate of puncture, incidence of vascular injury and that of catheter drift were analyzed.Results The differences of resistin, leptin, adiponectin, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 before and after the treatment in the ultrasound-guided group were higher than those in the direct vein puncture group (P < 0.05). The expression levels of IGFR-1 and IGF-1 protein in the ultrasound-guided group were lower than those in the direct vein puncture group, while the expression level of the PTEN protein was higher in the ultrasound-guided group relative to that in the direct vein puncture group (P < 0.05). The first puncture success rate and overall success rate were higher (P < 0.05), while the incidences of catheter drift and vascular injury were lower in the ultrasound-guided group than those in the direct vein puncture group (P < 0.05). The total effective rate of the ultrasound-guided group was higher than that of the direct vein puncture group (P < 0.05). The incidence of adverse reactions in the ultrasound-guided group was lower than that of the direct vein puncture group (P < 0.05).Conclusions The ultrasound-guided central venous catheterization can regulate the levels of adipokines and IGF-1 in patients with diabetes mellitus and gastric cancer, and reduce the incidences of vascular injury and catheter drift during the operation.