Objective To analyze the efficacy and safety of sitagliptin combined with metformin in the treatment of elderly patients with type 2 diabetes. Methods? The clinical data of 60 elderly patients with type 2 diabetes who were treated in Changqiao People's Hospital from January 2019 to January 2020 were retrospectively analyzed， and they were divided into conventional and test groups according to the treatment modality，with 30 patients each.The conventional group received metformin treatment，and the test group intervened with patients on the basis of the addition of sitagliptin to the conventional group.The treatment response rate，fasting blood glucose（FBG），2 h postprandial blood glucose（P2BG），glycated hemoglobin（HbA1c），and body mass index（BMI）as well as the incidence of adverse effects were compared between the two groups. Results? Through the comparison of research data，it was found that the treatment efficiency of the experimental group was higher than that of the conventional group（P＜0.05）.After treatment，the FBG，P2BG and HbA1c levels of the two groups all decreased，and the indexes of the experimental group were lower than those of the conventional group（P ＜0.05）. There was no statistically significant difference in BMI between the two groups（P＞0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups（P＞0.05），and no serious adverse reactions such as hypoglycemia occurred. Conclusion? Metformin for the treatment of elderly type 2 diabetes based on the intervention combined with sitagliptin，the effectiveness of the treatment can be improved，and the safety can be guaranteed，and the clinical application value can be borrowed.