The care of older people living with type 2 diabetes and frailty is a significant part of district nurses’ caseload. Type 2 diabetes is common in older people and increases the risk of frailty, while the weight loss associated with frailty increases the risk of hypoglycaemia, which is a major complication of diabetes. Hypoglycaemia has serious adverse consequences for older people, including cerebrovascular accidents, myocardial infarction, retinopathy, falls and fractures, and premature death. District nurses have an important role to play in optimising the treatment regimens of older people with diabetes type 2 and frailty, ensuring adequate glycaemic control while reducing the risk of hypoglycaemia. They are well placed to intervene early, identify functional decline, prevent overtreatment and minimise the risk of adverse events and worsening frailty. To fulfil that role, district nurses need multidisciplinary working with diabetes specialist teams, regular training to keep up to date with advances in diabetes care, and improved guidance on the management of type 2 diabetes in older people living with frailty.