OBJECTIVE： To observe the effects of sitagliptin phosphate combine with acarbose on blood glucose，blood lipid and the serum glucose transporter 4 （GLUT4） in elderly patients with type 2 diabetes. METHODS： 86 elderly patients with type 2 diabetes were randomly divided into control group and observation group， 43 cases in each group. All patients received guidance about diet， exercise and living habits， etc.， as well as the care about psychology and medication. Based on it， control group was given Acarbose tablet 50 mg/times，tid， chewing when a meal； observation group was given Acarbose tablet （the same dosage and usage） + Sitagliptin phosphate tablet 100 mg/times， qd， orally. They were treated for 3 months. Fasting blood glucose （FBG）， 2 h postprandial blood glucose （2 hPG）， glycosylated hemoglobin （HbAlc）， body mass index （BMI）， fasting insulin （FINs）， insulin resistance index （HOMA-IR）， islet B-cell function index （HOMA-B）， total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C） before and after treatment in 2 groups were compared， the incidence of adverse reactions was recorded. Other 43  healthy people were selected as healthy control group， the differences of serum GLUT4 levels before and after treatment between the 2 groups and healthy control group were respectively compared. RESULTS： After treatment， the BMI， FBG， 2 hPG， HbAlc， HOMA-IR，FINs，TC， TG and LDL-C level were significantly lower than before， observation group was lower than control group； HOMA-B and HDL-C level were significantly higher than before， observation group was higher than control group， with statistical significance （P＜0.05）. Before treatment，the  serum GLUT4 level in 2 groups were significant lower than healthy control  group with satistical significance（P＜0.05）；after treatment， the serum GLUT4 level in control group there was no significant different than before（P＞0.05），while the serum GLUT4 level in observation group was significant higher than before and control group； and the serum GLUT4 level in 2 groups were still significant lower than healthy control group（P＜0.05）. And there was no significant difference in the incidence of adverse reactions （P＞0.05）. CONCLUSIONS： Sitagliptin phosphate combine with acarbose can effectively control patients’ blood glucose and lipid levels in the treatment of elderly patients with type 2 diabetes， improve HOMA-B and serum GLUT4 level， and does not increase the incidence of adverse reactions， with good safety.