The elderly are more likely to develop diabetes mellitus. More than half of the diabetic patients are elderly individuals. The outcome of these patients differs greatly due to the complex of the condition, the variety of complicated diseases, and multiplicity of the influencing factors. So, it is very important to evaluate their accommodation ability, the function of the major organs, and the level of self-management to establish the individualized treatment strategy and blood glucose control target for different patients. The modification of life style is the basic treatment option for metabolic disorder. Early diagnosis and treatment are decisive to the patients? prognosis. Metformin, glycosidase inhibitors and dipeptidyl aminopeptidase inhibitors are the first-line oral antidiabetic drugs. The timely use of insulin is beneficial for the control of blood glucose. The comprehensive control of multiple cardio-vascular risk factors, especially the blood pressure and body weight control, should be emphasized.