Abstract: Objective Accelerating aging of population, the increasing prevalence of type 2 diabetes, and elderly patients with type 2 diabetes prone to adverse emotions, affect glycemic control and quality of life, and to explore the effects of mental health guidance on elderly patients with type 2 diabetes and their families in the community. Methods At the end of 2015, Changqiao Community Health Service Center included diabetes patients with chronic disease management, with 600 cases who met the criteria and were selected by random number table method, and then ranked by random number. According to single and double numbers, the intervention group and the control group were divided into 300 cases in each group. Both groups of patients were given diabetes medical treatment, diet control, exercise therapy, blood glucose monitoring, and health education. On the basis of this, the intervention group conducted a one-year mental health guidance training for patients and their families, and the family members cooperated with the physicians to conduct comprehensive psychological education-type family intervention for diabetic patients. The double-blind method was used to measure the scales, and the results of the two groups were compared and analyzed. All data were analyzed by SPSS 20.0 software for statistical analysis, using descriptive statistical analysis and t test. Results One year later, 287 cases (95.7%) of the intervention group completed the guide and 13 cases (4.3%) were detached, while in the control group, 288 cases (96.0%) completed, and 12 cases (4.0%) were detached. The causes of detachment were death, relocation, and going abroad. Zung Self-Rating Depression Scale (SDS), Zung self-rating anxiety scale (SAS), fasting blood glucose (FBG), postprandial 2-hour blood glucose (PBG), glycosylated hemoglobin (HbA1 C) determination in intervention group were all lower than those in the control group, while the quality of life questionnaire (SF-36) scale in the intervention group was higher than that in the control group (all P<0.05). Conclusion Conducting mental health guidance for elderly patients with type 2 diabetes in the community has a positive impact on patients' blood glucose control and quality of life.