The increase proportion of older persons is continuously growing in worldwide, especially in Japan. Subsequently, the number of older adults with type 2 diabetes is also increasing. Older adults with diabetes are at substantial risk of frailty, cognitive impairment, and physical disability. They are also at greater risk for polypharmacy, depression, urinary incontinence, injurious fall, and persistent pain. Thus, older patients are a very heterogenous group of individuals. Hypoglycemia is a frequent adverse effect of treatment with sulfonylurea, glinides, or insulin in older adults with diabetes. In this review, we describe the efficacy and safety of some anti-diabetic oral agents used in older adults with type 2 diabetes, including an incretin-based drug dipeptidyl peptidase 4(DPP4) inhibitors.