GFAP and type 2 diabetes mellitus: This manifestation has not been fully reported, which supplements the imaging heterogeneity of GFAP-A and also suggests that clinicians should not rule out this disease due to negative brain MRI findings, but should comprehensively judge based on CSF antibody detection and spinal cord MRI.Herein, we report a GFAP-A patient with 13-year type 2 diabetes mellitus and multiple infections, who presented with isolated spinal cord enhancement, to provide insights for disease identification in complex clinical scenarios.