Objective To investigate the effects of liraglutide and insulin glargine on blood glucose fluctuations and lipid levels in type 2 diabetic patients.Methods The 174 patients with type 2 diabetes admitted to our hospital from June 2022 to October 2022 were selected and divided into the liraglutide group and insulin glargine group by the random number table method, with 87 cases in each group. The liraglutide group was treated with liraglutide, while the insulin glargine group was treated with insulin glargine. The body mass index (BMI), blood glucose, blood lipids, blood glucose fluctuations, and adverse reactions were compared between two groups before and after treatment.Results There was no significant difference in the overall effective rate between the two groups (P > 0.05). The difference of BMI before and after treatment in the liraglutide group was lower than that in the insulin glargine group (P < 0.05). The differences of the standard deviation of the level of blood glucose, mean amplitude of glycemic excursions, largest amplitude of glycemic excursions and average daily blood glucose before and after treatment in the liraglutide group were higher than those in the insulin glargine group (P < 0.05). Before treatment, the time in range (TIR), time above range (TAR), and time below range (TBR) during time slots from 6:00 to 14:00, 14:00 to 22:00, and 22:00 to 6:00 the next day in the two groups were compare via repeated measures analysis of variance, which exhibited that there was no statistically significant difference in TIR, TAR and TBR among different time slots (P > 0.05) or between the groups (P > 0.05), and that the change trends of TIR, TAR and TBR were not different between the groups (P > 0.05). Similar comparison after treatment demonstrated that there were statistically significant differences in TIR, TAR and TBR among the time slots (P < 0.05) and between the groups (P < 0.05), and that the efficacy of liraglutide in controlling blood glucose fluctuations was superior to that of insulin glargine. Besides, the change trends of TIR, TAR and TBR were different between the groups (P < 0.05). The differences of levels of total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol before and after treatment in the liraglutide group were higher than those in the insulin glargine group (P < 0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (P > 0.05).Conclusion Though insulin glargine can reduce blood glucose fluctuations in patients with type 2 diabetes, it is significantly less effective when compared with liraglutide. In addition, liraglutide shows greater efficacy in improving blood lipid levels than insulin glargine.