To properly manage diabetes in older adults, a comprehensive assessment of clinical, functional, psychological, and socioeconomic factors is required. Treatment goals should be individualized. Before establishing glycemic objectives and a treatment strategy, it is important to consider each patient’s general health, preexisting medical conditions, personal preferences, coping abilities, and other factors affecting the quality of life. Older adults are at higher risk for diabetes complications such as hypoglycemia. Treatment goals should be patient-specific, tailored to the older adult’s needs, and incorporate a shared decision-making process.