Objective To investigate the effects of Acarbose combined with Metformin on blood glucose, insulin-related indexes and blood lipid levels in patients with type 2 diabetes mellitus. Methods A total of 90 patients with type 2 diabetes mellitus who were admitted to Hubei Rongjun Hospital from March 2020 to March 2021 were divided into the control group (45 cases) and the observation group (45 cases) according to the random number table. Patients in both groups were treated with the conventional treatment of exercise and diet intervention. On the basis of conventional treatment, patients in the control group were treated with Metformin hydrochloride tablets, and patients in the observation group were treated with Acarbose tablets on the basis of the control group. Both groups were treated for 3 months. Blood glucose, insulin-related indexes, blood lipid and oxidative stress indexes before and after treatment and the occurrence of adverse reactions during treatment of patients in the two groups were compared. Results Compared with before treatment, after treatment, the serum fasting blood glucose (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), homa insulin-resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), malondialdehyde (MDA), reactive oxygen species (ROS) of patients in the two groups decreased, and the observation group was lower than the control group; After treatment, the levels of serum high density lipoprotein cholesterol (HDL-C) and superoxide dismutase (SOD) of patients in the two groups increased, and the observation group was higher than the control group; during treatment, the occurrence of adverse reactions in the observation group (11.11%) was lower than that in the control group (28.89%) (all P <0.05). Conclusion Acarbose combined with Metformin can reduce blood glucose and lipid levels of patients with type 2 diabetes mellitus, improve insulin-related indicators, and relieve oxidative stress response, with high safety and significant therapeutic effect.