Objective To evaluate the application effect of exercise diet based blood glucose control in elderly preg-nant women with diabetes.Methods A total of 140 elderly pregnant women with diabetes in pregnancy who were ad-mitted to Shouguang People's Hospital of Shandong Province from January 2019 to June 2022 were selected as the study objects.Random number table method was used to divide into two groups(control group and observation group).The control group consisted of seventy cases who received routine prenatal care,while the observation group consisted of seventy cases who received exercise diet guidance on the basis of the control group.The blood glucose levels,ad-verse pregnancy outcomes,and neonatal adverse outcomes between two groups were compared.Results The observa-tion group had lower fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,total incidence of adverse pregnancy outcomes,and total incidence of neonatal adverse outcomes compared to the control group,and the differences were statistically significant(all P<0.05).Conclusion In the elderly pregnant women with diabetes during pregnancy,exercise diet based blood glucose control can effectively reduce the blood glucose level of patients,and can improve the pregnancy outcome and neonatal outcome of patients.