Abstract： Objective To investigate the efficacy of saxagliptin and metformin combined with insulin aspart in the treatment of type 2 diabetes mellitus(T2DM).Methods A total of 80 T2DM patients admitted to Fengxian People's Hospital from January 2022 to January 2024 were selected as the study objects and divided into two groups according to random number table method,with 40 cases in each group.All patients were treated with insulin aspartate after ad-mission,the control group was treated with oral metformin,and the observation group was treated with metformin com-bined with saxagliptin.The efficacy,glucose and lipid metabolism indexes,islet function and side effects were com-pared between the two groups.Results After treatment,fasting plasma glucose,glycated hemoglobin,2 hours postpran-dial plasma glucose,low density lipoprotein cholesterol,cholesterol and triglyceride levels in observation group were lower than those in control group,and high density lipoprotein cholesterol level was higher than that in control group,and the differences were statistically significant(all P<0.05).After treatment,the insulin resistance index and fasting insulin levels in observation group was lower than that in control group,and the islet β cell function index and insulin sensitivity index were higher than that in control group,and the difference was statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Saxagliptin and metformin combined with insulin aspart can significantly improve glucose and lipid me-tabolism and insulin resistance in the treatment of type 2 diabetes mellitus.