Objective: To investigate the intestinal flora in elderly patients with type 2 diabetes mellitus with early nephropathy. Methods: 43 elderly patients with type 2 diabetes mellitus with early nephropathy (diabetic nephropathy group) and 51 elderly patients with type 2 diabetes mellitus (type 2 diabetes mellitus group) admitted to our hospital from January 2021 to October 2022 were retrospectively analyzed, with 39 healthy people who underwent a physical examination in our hospital during the same period as the control group. The fecal specimens of the three groups were collected, and the 16S rDNAs of bacteria in the fecal samples were extracted, amplified, and sequenced for intestinal flora operational taxonomic unit (OTU) classification and Alpha diversity analysis. Results: (1) Intestinal flora OTUs: there were 545 intestinal flora OTUs unique to the control group, 424 intestinal flora OTUs unique to diabetic nephropathy, and 321 intestinal flora OTUs unique to the type 2 diabetes group. There were 403 intestinal flora OTUs common to the control group and diabetic nephropathy group, 256 intestinal flora OTUs common to the control group and type 2 diabetes group, and 298 intestinal flora OTUs common to the type 2 diabetes group and diabetic nephropathy group. 235 intestinal flora OTUs were common to all 3 groups of subjects. (2) Alpha diversity: The statistical analysis indicated that there was a statistically significant difference (P < 0.05) in the Alpha diversity of intestinal flora, as assessed by the Ace index and Simpson’s index, among the three subject groups. However, no statistical significance (P > 0.05) was observed when comparing the Chao 1 index and Shannon index. Further observation of the Ace index and Simpson index in the three groups revealed that both the diabetic nephropathy group and the type 2 diabetes mellitus group had lower values than the control group. Conclusion: The diversity of intestinal flora decreases in elderly patients with type 2 diabetes mellitus with early nephropathy.
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