Introduction. Frailty syndrome and type 2 diabetes mellitus (T2DM) are age-associated diseases associated with changes in body composition, including increased fat mass, central fat distribution, decreased lean mass and skeletal muscle. Aim: to assess gender differences in body composition in elderly and senile patients with T2DM and pre-frailty. Materials and methods: The study included 192 patients (mean age 73.04±5.73 years) with pre-frailty (98 of them had T2DM, 94 without T2DM). All study participants were given complaints, anamnesis, anthropometric parameters, MNA, ADL, IADL, MoCA, GDS, FRAIL, EQ-VAS scales, handgrip strength, and walking speed. Body composition was determined using the bioimpedance method. Results: Minor intra-gender differences were found: body mass index (BMI) (p = 0.008) and waist circumference (WC) (p = 0.038), fat (p = 0.014) and lean (p = 0.026) mass indices, and the prevalence of obesity (p = 0.039), determined by the percentage of fat tissue, were significantly higher in women with T2DM than without it. Significant intergender differences were found in the presence of T2DM: women with T2DM had a significantly lower subjective perception of their health (EQ-VAS, p=0.03), MoCA (p=0.016), SPPB (p=0.004) test results, handgrip strength (p