In the coming decades, the population of older adults with diabetes is expected to grow substantially. To guide care guidelines and policy decisions, Huang and coauthors characterized the contemporary clinical course of diabetes by age and diabetes duration categories, using a cohort of 72 310 patients older than 60 years with type 2 diabetes mellitus enrolled in an integrated health care delivery system. They found that among older adults with diabetes of short duration, cardiovascular complications followed by hypoglycemia were the most common nonfatal complications. For a given age group, rates of each outcome, particularly hypoglycemia and microvascular complications, increased dramatically with longer duration. However, for a given duration of diabetes, rates of hypoglycemia, cardiovascular complications, and mortality increased steeply with advancing age, while rates of microvascular complications remained stable or declined.