The *Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition)* is a comprehensive clinical guideline aimed at improving the management and clinical outcomes of diabetes in older adults in China. The guideline, developed by experts from the National Center of Gerontology, Chinese Society of Geriatrics, and Diabetes Professional Committee of Chinese Aging Well Association, emphasizes the heterogeneity of older patients with diabetes and advocates for comprehensive assessment and individualized management strategies. Key points include: 1. **Epidemiology**: The prevalence of diabetes increases with age, with China having the highest number of older patients with diabetes globally. 2. **Diagnosis and Classification**: The guideline uses the 1999 WHO diagnostic criteria and classifies diabetes into T1DM, T2DM, and special types. It highlights the unique characteristics of diabetes in older adults, such as atypical symptoms and multiple complications. 3. **Prevention**: Primary, secondary, and tertiary prevention strategies are outlined to reduce the incidence of diabetes and its complications. 4. **Comprehensive Geriatric Assessment (CGA)**: CGA is recommended to assess the health status of older patients with diabetes, which helps in developing individualized treatment plans. 5. **Health Education**: Individualized health education is crucial to help patients understand diabetes, manage their condition, and improve quality of life. 6. **Glycemic Goals**: Glycemic goals should consider the benefit-to-risk ratio and be stratified based on health status. Glucose variability is also monitored. 7. **Lifestyle Interventions**: Lifestyle interventions, including medical nutrition therapy and exercise, are emphasized as fundamental treatments. 8. **Medications**: The guideline provides recommendations for various glycemic medications, including metformin, sulfonylureas, glinides, alpha-glucosidase inhibitors, thiazolidinediones, DPP-4 inhibitors, and SGLT2 inhibitors, with considerations for their use in older patients. The guideline aims to provide practical and operable clinical guidance to improve the management of diabetes in older adults in China, promoting comprehensive and standardized care.The *Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition)* is a comprehensive clinical guideline aimed at improving the management and clinical outcomes of diabetes in older adults in China. The guideline, developed by experts from the National Center of Gerontology, Chinese Society of Geriatrics, and Diabetes Professional Committee of Chinese Aging Well Association, emphasizes the heterogeneity of older patients with diabetes and advocates for comprehensive assessment and individualized management strategies. Key points include: 1. **Epidemiology**: The prevalence of diabetes increases with age, with China having the highest number of older patients with diabetes globally. 2. **Diagnosis and Classification**: The guideline uses the 1999 WHO diagnostic criteria and classifies diabetes into T1DM, T2DM, and special types. It highlights the unique characteristics of diabetes in older adults, such as atypical symptoms and multiple complications. 3. **Prevention**: Primary, secondary, and tertiary prevention strategies are outlined to reduce the incidence of diabetes and its complications. 4. **Comprehensive Geriatric Assessment (CGA)**: CGA is recommended to assess the health status of older patients with diabetes, which helps in developing individualized treatment plans. 5. **Health Education**: Individualized health education is crucial to help patients understand diabetes, manage their condition, and improve quality of life. 6. **Glycemic Goals**: Glycemic goals should consider the benefit-to-risk ratio and be stratified based on health status. Glucose variability is also monitored. 7. **Lifestyle Interventions**: Lifestyle interventions, including medical nutrition therapy and exercise, are emphasized as fundamental treatments. 8. **Medications**: The guideline provides recommendations for various glycemic medications, including metformin, sulfonylureas, glinides, alpha-glucosidase inhibitors, thiazolidinediones, DPP-4 inhibitors, and SGLT2 inhibitors, with considerations for their use in older patients. The guideline aims to provide practical and operable clinical guidance to improve the management of diabetes in older adults in China, promoting comprehensive and standardized care.