Management of elderly people with type 2 diabetes mellitus (DM) is aimed at attaining optimal levels of serum glucose, avoiding hypoglycemic episodes, preventing the acute complications of uncontrolled hyperglycemia, and preventing or delaying the progression of the chronic complication of diabetes. Moreover, the principles of managing type 2 diabetes mellitus in the elderly are no different from those in younger, but the priorities and therapeutic strategies need to be cautiously individualized. The objectives of treatment are to improve glycaemic control in a stepwise approach that involves non pharmacological methods including diet and exercise, and pharmacological therapy including mixtures of oral anti hyperglycemic agents alone or in combination with insulin. Furthermore, diet and exercise remains the cornerstone of diabetes management. Diet should be designed to provide sufficient calories to achieve or maintain ideal bodyweight.