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To assess the effectiveness of Western medicine and TCM treatment for the improvement of glycaemia control, quality of life, and reducing complications among type 2 diabetes elderly patients in an urban community, a total of 132 elderly patients with type 2 diabetes (aged ≥ 60 years) were randomly allocated to either treatment or placebo control. The intervention group received a comprehensive TCM treatment regimen, including herbal medicine, acupuncture, massage, and dietary therapy, along with lifestyle changes. The control received the standard Western medical treatment. Blood glucose levels were measured upon arrival and again 2 h later. Glycated haemoglobin (HbA1c) was monitored over the duration of the study. In addition, lipid profiles were assessed. Quality of life was evaluated using the Diabetes-Specific Quality of Life Scale (DSQL). Other complications were also recorded. The secondary outcomes measured other kinds of social support (Social Support Rate Scale, SSRS) and health risk (WONCA scale). Compared to the control group, those in the TCM intervention group had better glycemic management, with significant improvements in fasting blood glucose (FBG) (6.82 ± 0.94 vs. 9.34 ± 1.43 mmol/L, P < 0.05) and HbA1c (6.51 ± 0.65% vs. 7.82 ± 0.88%, P < 0.05). Furthermore, the TCM intervention group had better lipid profiles and a higher DSQL score (21.25 ± 3.65 vs. 28.32 ± 4.89, P < 0.05). Finally, they did not suffer from TCM complications (1.52% vs. 10.61%, P < 0.05). Those in the intervention group also had significantly higher social support scores (SSRS; P < 0.05). Therefore, using TCM together with other treatments has a greater effect on the blood glucose, life quality, and diabetic complications of older diabetic patients in a community.