Patients with elderly-onset diabetes have specific characteristics. This study was designed to investigate these characteristics and to evaluate methods for appropriate control of glycaemia and cardiovascular risk factors in elderly-onset diabetes patients. A total of 155 elderly patients with type 2 diabetes mellitus were divided into those diagnosed at >= 65 years of age (elderly-onset group, 75 patients) and those diagnosed at < 60 years of age (usual-onset group, 80 patients). Differences in clinical variables, diabetic complications, diagnosed comorbidities and the use of medications were analysed. Mean glycosylated haemoglobin, fasting plasma glucose and fasting insulin levels were significantly lower in the elderly-onset group than in the usual-onset group. The usual-onset group showed significantly greater homeostasis model assessment insulin resistance than the elderly-onset group. Microvascular complications and insulin use were significantly more common in the usual-onset group. In conclusion, insulin resistance was less severe in elderly-onset diabetes than in usual-onset diabetes. As hyperglycaemia was relatively mild or moderate, oral hypoglycaemic agents might be effective for elderly-onset diabetes.