Summary: Older patients with diabetes have a significantly greater risk of hypoglycemia. Many factors influence hypoglycemia risk: increasing age, physical and cognitive disability, frailty and sarcopenia, renal failure, and other accompanying diseases, as well as the use of insulin and sulfonylureas. Due to the negative consequences of hypoglycemia in old age, avoiding it is becoming a priority in treating patients. Therefore, it is essential to properly select hypoglycemic drugs, as they differ in hypoglycemia risk. Diabetes therapy should consider individual patients' characteristics and comprehensive geriatric assessment results. Educating older patients and their caregiver is essential in the hypoglycemia prevention strategy. In addition, it should consider the principles of glycemic monitoring, detection, and management of hypoglycemia.