Diabetes mellitus type 2 is a chronic metabolic disorder associated with high levels of blood glucose, insulin resistance, and relative lack of insulin. Risk factors for type 2 diabetes include obesity, lack of exercise, and genetic predisposition. About 90% of cases of diabetes are type 2, and 10% type 1 and gestational diabetes. If inadequately treated, complications occur almost always, including heart disease, stroke, visual loss, kidney failure, and low blood flow to the limbs leading to infections, gangrene, and amputations. These complications result from macro-and microvascular problems [1]. By contrast, too tight a control can lead to harmful hypoglycemia. The literature to date reports no significant impact of tight glycemic control on the risk of dialysis/transplantation/renal death, blindness, or neuropathy [2]. According to the American Diabetes Association, one of 3-4 individuals aged >65 years has diabetes [3]. Annual screening in older adults permits early detection of individuals at risk for diabetes. Glucose control decreases microvascular events [1, 4-8]. The effect is proportional to glycated hemoglobin (HbA 1c) reduction and is preserved over time [4, 5]. Long-term follow-up also shows a benefit on cardiovascular morbidity and mortality [4, 5]. Delayed intervention may not confer a similar benefit [3-8]. Diabetes may be complicated by chronic infections such as tuberculosis that increase the burden of illness [9]. Early intensive multifactorial intervention can be costeffective in preventing 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening [10]. Glycemic and metabolic goals in older adults with diabetes depend on health status, life expectancy, and the number and complexities of complications [11].