Studies show that the prevalence of type 2 diabetes among adults aged 65 and older in the United States ranges between 20% and 25%. However, controversy has surrounded the most appropriate approaches to treating and managing diabetes in older adults, particularly with regard to identifying therapeutic targets for A1C and the control of other cardiovascular risk factors. In addition, research suggests there are disparities in risk factor control among racial and ethnic minorities with diabetes when compared with whites who have the disease. Diabetes continues to be a major public health problem among older racial and ethnic minorities. There are important factors to consider when managing this older patient group and developing treatment targets. These include the potential for adverse effects when using pharmacologic treatment, risks for hypoglycemia, and individual comorbidities, among other factors.