Diabetes management in the elderly requires a nuanced, patient-centered approach due to age-related physiological changes, comorbidities, and increased vulnerability to complications. Key considerations include individualized glycemic targets, careful selection of pharmacological therapies to minimize hypoglycemia, and comprehensive management of cardiovascular, renal, and cognitive comorbidities. Lifestyle interventions, including tailored nutrition, safe physical activity, and social support, are crucial for maintaining functional independence and overall health. Regular monitoring, education, and interdisciplinary care help optimize outcomes while addressing unique challenges such as polypharmacy, frailty, and cognitive impairment. By adopting age-appropriate strategies, healthcare providers can improve quality of life, reduce complications, and ensure safe and effective diabetes care in the elderly population.