Objective To explore the efficacy and safety of Acarbose and Insulin in the treatment of elderly type 2 diabetes.Methods A total of 76 patients with type 2 diabetes who visited the Department of Outpatient in Zibo Zhoucun District Center for Disease Control and Prevention from January 2019 to June 2020 were selected as the research subjects.According to the random number table method, they were divided into conventional group (38 cases) and combined group (38 cases).The conventional group was treated with Insulin, and the combined group was treated with Acarbose on the basis of the routine group.The blood glucose, insulin function and the total incidence of adverse reactions were compared between the two groups before and after treatment.Results There was no significant difference in glycated hemoglobin (HbA1c), fasting blood-glucose (FBG) and 2 h postprandial blood glucose (2 h PG) between the two groups before treatment (P＞0.05).HbA1c, FBG, and 2 h PG in the combination group after treatment were lower than those in the conventional group, the differences were statistically significant (P＜0.05).There were no significant differences in the islet B cell function index (HOMA-B) and insulin resistance index (HOMA-IR) between the two groups before treatment (P＞0.05).HOMA-B level after treatment in the combination group was higher than that of the conventional group, and HOMA-IR was lower than that of the conventional group, the differences were statistically significant (P＜0.05).The total incidence of adverse reaction in the combination group was lower than that in the conventional group, and the difference was statistically significant (P＜0.05).Conclusion Acarbose combined with Insulin can better regulate the blood glucose level of patients, effectively improve the insulin function of patients, and has a higher drug safety, which is worthy of extensive promotion and application.