〔Abstract〕 Objective To investigate the effects of TCM (traditional Chinese medicine) syndrome differentiation diet management on blood glucose and blood lipid metabolism and body mass index (BMI) in type 2 diabetes mellitus (T2DM) patients. Methods A total of 80 T2DM patients admitted to Shangqiu Hospital of Traditional Chinese Medicine from January 2019 to February 2020 were selected and randomly divided into an observation group and a control group, with 40 cases in each group. Patients in the control group were treated with traditional diet management on the basis of conventional drug therapy, while patients in the observation group were treated with TCM syndrome differentiation diet management on the basis of conventional drug therapy. Before management and 3 months after management, fasting venous blood was taken from patients, and the levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2h PBG), triglyceride (TG), total cholesterol (TC) and glycosylated hemoglobin (HbA1c) were measured, and the changes of glucose and lipid metabolism related indicators were observed. BMI was measured, and TCM syndrome scores were counted before and after the implementation of management. Results After treatment, the levels of FBG, 2h PBG, TG, TC and HbA1c in the two groups were decreased to varying degrees, and the levels of FBG, 2h PBG, TG, TC and HbA1c in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). After treatment, the BMI of the two groups decreased to varying degrees, and the BMI of the observation group was lower than that of the control group, the differences were statistically significant (P < 0.05). After treatment, the scores of symptoms of bitter mouth, anorexia and complexion were decreased in the two groups, and the differences were statistically significant (P < 0.05). After treatment, there was no statistical significance in the scores of symptoms of bitter mouth, anorexia and atrophic complexion between the two groups (P > 0.05). Conclusion Dietary management based on TCM syndrome differentiation can effectively improve blood glucose and blood lipid metabolism and control body weight development in T2DM patients.