Objective To study the relationship between insulin resistance and renin-angiotensin-aldosterone system (RASS) in newly diagnosed type 2 diabetes mellitus, and to provide the best treatment for type 2 diabetes mellitus with hypertension . Methods Ninety cases of newly diagnosed type 2 diabetes mellitus were included. After stratified by gender, all the patients were divided into hypertension group and non-hypertension group. According to whether taking hypotensor, the patients with hypertension were further divided into non-medication group, calcium channel blockers (CCB) group, and angiotensin receptor blockers (ARB) group respectively. Results In female patients with hypertension, the IAI, levels of rennin and angiotensin II were higher than those in non-hypertension group and the systolic pressure of female patients taking ARB was lower than those taking CCB. Pearson′s correlation analysis showed that angiotensin II and aldosterone was positively correlated with HOMA-IR but negatively correlated with IAI in females. Conclusions In female newly diagnosed type 2 diabetes mellitus , RASS is related to the development of insulin resistance , so RASS antagonists are the first choice to achieve better blood glucose control in female patients.