The high prevalence of geriatric syndromes accompanied with type 2 diabetes mellitus in elderly, such as frailty syndrome, malnutrition, dementia, mood disorder, disability, is getting more and more concern. However geriatric syndromes were seldom taken into consideration in guidelines released by diabetic association. The epidemiology features of malnutrition, dementia, mood disorder, and disability were reviewed; the optimal individualized HbA1c value and the comprehensive strategy for elderly diabetic patient were also discussed.