Objective To explore the association between different glucose metabolism status and death from all causes, cardio-cerebrovascular diseases in middle-aged and elderly population. Methods Totally 981 community residents aged 35 years and above in Qingpu district, Shanghai were enrolled in 2009 and a 15-year follow-up study of epidemiological survey on type 2 diabetes mellitus (T2DM) among them were conducted. Cox proportional hazards regression model was used to analyze hazard ratio (HR) of all-cause mortality, cardio-cerebrovascular mortality and their 95%CI in middle-aged and elderly population with different glucose metabolism status. Results The cumulative follow-up period was 14 464.01 person-years. During this period, 114 subjects died, and all-cause death density were 788.16/100 000 person-years. In which, 30 patients were dead from cardio-cerebrovascular diseases, and its death density was 207.41/100 000 person-years. Compared with the population with normal sugar metabolism, the risk of all-cause death in patients with prediabetes increased 77%, all- cause death and cardio- cerebrovascular diseases cause death in T2DM patients increased 155% (HR=2.55, 95%CI: 1.53-4.25) and 299% (HR=3.99, 95%CI:1.52-10.45), respectively. Stratified by age, the risk of cardio - cerebrovascular disease caused death in people under 60 years with prediabetes was higher than that in people with normal glucose metabolism (HR=6.91, 95%CI：1.19-40.07), and the risk of all - cause death and cardio - cerebrovascular death in T2DM patient over 60 years was higher than that in people with normal glucose metabolism (HR=2.64，95%CI：1.42-4.90；HR=4.87，95%CI：1.62-14.62). Conclusions Prediabetes and T2DM were important risk factors for all - cause death and cardio - cerebrovascular diseases death in middle-aged and elderly people. Targeted classified prevention and early intervention of blood sugar should be implemented to reduce all-cause death and cardio-cerebrovascular diseases death.