In Italy, about 20% of elderly subjects over 75 years suffer from type 2 diabetes mellitus. Diabetes accelerates all aging mechanisms, increasing morbidity and mortality rates of the geriatric population and contributing significantly to the worsening of age-related conditions such as functional and cognitive decline. Multidimensional Geriatric Assessment (MGA) globally evaluates geriatric patients by integrating information on their functional, cognitive, physical, socio-economic and nutritional status. Therefore, it is very important to plan an individualized management in order to reach the best therapeutic adherence. The aim of antidiabetic treatment in geriatric patients must be based on the prevention of events that may cause a worsening of the patient’s functional status and on the improvement of quality of life.