Abstract： Objective To explore the efficacy and safety of acarbose combined with metformin in elderly patients with diabetes.Methods A total of 80 elderly diabetic patients admitted to Ulanqab Second Hospital from September 2021 to September 2023 were selected as the study objects and divided into two groups according to random number table method,with 40 cases in each group.The control group was given metformin treatment,and the observation group was given metformin+acarbose treatment.The clinical efficacy,blood glucose difference before and after treatment and the occurrences of adverse reactions were compared between the two groups.Results The total effective rate of the ob-servation group was higher than that of the control group,and the difference was statistically significant(P<0.05).Be-fore treatment,there was no significant difference in blood glucose level between the two groups(P>0.05).After treat-ment,the blood glucose level of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Acarbose combined with metformin is more effective in elderly patients with diabe-tes,and can significantly reduce the blood glucose level of patients with high safety.