In elderly type 2 diabetes, treatment of hyperglycemia has to be integrated into global and individualized care, driven by geriatric assessment In addition to avoiding lethal complications of diabetes, the prevention of decrease in the level of functional independence is the most important goal of this care, and must be implemented by taking into account the type of patient, vigourous or frail. For the dependent patient, maintaining comfort becomes the priority goal. From this assessment ensue the therapeutic and glycemic goals. The choice of therapeutic tools is a function of fixed goals, of comorbidities, of the organization of care at home or in nursing homes, and of the atrogenic risk, in particular the undernutrition and the hypoglycemia.