Objective To study the correlation between the course of disease and bladder dysfunction in middle-aged and elderly women with type 2 diabetes mellitus. Methods From January 2017 to September 2018, 217 outpatient service age of 40 or more female patients with type 2 diabetes were selected as the research object, according to the course, all patients were divided into < 10 years group(n=126) and group of 10 years or more(n=91). All patients underwent urine dynamics test, and early abnormal amount of sense to urinate, abnormal detrusor contraction force, residual urine volume increased, detrusor without inhibitory and detrusor sphincter contraction uncoordinated incidence of two groups were compared. Symptoms and severity of bladder hyperactivity were investigated by OABSS scale. Then, the course of the disease was taken as the independent variable, and the severity of symptoms of bladder hyperactivity and the indicators of urodynamics with statistical significance were taken as dependent variables. The correlation between the severity of the symptoms and the course of the disease was analyzed by multifactor unconditioned logistic regression. Results The incidence of the patients with the duration of the disease greater than or greater than 10 years in the group with abnormal initial urinary intention, abnormal detrusor contractility, and non-inhibitory detrusor contractility was 65.93%, 82.42%, and 79.12%, respectively, which were significantly higher than the rates of 40.48%, 49.21%, and 36.51% in the 0.05). The proportion of patients with symptoms of bladder hyperactivity in the group with a course greater than 10 years was 51.65%, significantly higher than 23.02% in the group with a course greater than 10 years, and the proportion of patients with moderate or severe disease greater than 10 years was significantly higher than that in the group with a course greater than 10 years, with statistically significant difference(P<0.05). Multivariate logistic regression analysis showed that the course of the disease was associated with symptoms of bladder hyperactivity, abnormal initial urinary sense, and abnormal detrusor contractility. Conclusions The course of disease in elderly women with type 2 diabetes mellitus is closely related to the symptoms and severity of bladder hyperactivity and abnormal rate of urodynamic examination, suggesting that the diagnosis of bladder dysfunction should be emphasized in patients with long course of disease. Key words: Diabetes Mellitus, Type 2; Aged; Femininity; Urinary Bladder, Overactive