Practitioners are increasing confronted to the management of type 2 diabetes (T2DM) among older patients. Specificities of the elderly should be considered, especially fragility and geriatric syndromes, and glycaemic objectives should be adapted according to the patient's individual profile, «vigorous», «fragile» or «ill», being stricter in individuals with the longer life expectancy. The basics of the therapy of T2DM are similar in older patients as in younger patients with, however, some specificities. A key objective is to avoid hypoglycaemic episodes that are particularly feared among older patients. The therapeutic approach should be personalized. It should take into account both patient's quality of life and environment as well as the presence of comorbidities that could influence the drug choice, for instance atheromatous cardiovascular disease, heart failure and chronic kidney disease.