Abstract: To explore the pathogenesis of type 2 diabetes mellitus(T2DM) based on the trinity life view of physique-qi-spirit, and point out that the occurrence and development of T2DM are the three elements of life, i.e. physique, qi and spirit, which have pathological changes. This paper discusses from three aspects: physique, qi, and spirit. The changes in physique include structural changes, abnormal physical movements, and changes in tangible and subtle substances; the changes in qi include qi deficiency and abnormal qi transformation; the changes in spirit include carnal desire excess and emotional imbalance. This paper provides new ideas for the clinical diagnosis and treatment of T2DM.