OBJECTIVES: To evaluate weight change and glycemic control in patients age 65+ with type 2 diabetes (T2DM) in a usual-care setting. METHODS: Treatment naïve patients age 65+ years with T2DM and a prescription (index date) for a sulfonylurea (SU), metformin (MET), thiazolidinedione (TZD), GLP-1 agonist (GLP-1), or DPP-4 inhibitor (DPP-4) were identified in an electronic medical record database from 1/1/2000 to 6/30/2010. HbA1c <7% or ≥7% and weight gain or loss of ≥3% were assessed 1 year post-index. Logistic regression identified the likelihood of weight loss and attaining HbA1c goal by antidiabetic drug class, controlling for baseline HbA1c and weight, and for weight change for HbA1c goal attainment. RESULTS: Of 12,473 patients, 46.4% were male and the mean age was 71.7 (±3.9) years. At baseline 26.7% had HbA1c <7.0%; mean weight 86.8 (±18.7) kg.  Breakdown by drug class was: SU - 31.0%, MET - 55.0%, TZD - 11.6%, DPP-4 - 1.9%, and GLP-1 - 0.6%. At 1 year, 34.8% lost ≥3% of body weight and 46.5% had an HbA1c <7.0%.  In logistic regression analyses, MET and DPP-4 (OR 1.4 and 1.36; p<.05) were associated weight loss relative to SU, TZDs were negatively associated with weight loss (OR 0.86; p<.05), and GLP-1 did not differ (OR 1.55; p=0.08). Patients who lost weight were 2.26 times as likely as those who did not to attain HbA1c goal (p<.05). Drug class was not associated with HbA1c goal attainment (p>0.05). CONCLUSIONS: In patients with T2DM age 65+, those who lost weight were more likely to attain HbA1C goal than those who did not. MET and DPP-4 were associated with weight loss vs. SU, but drug class was not associated with HbA1C goal attainment. These findings support guideline recommendations to consider weight-effect properties of antidiabetics in treating T2DM with data specific to patients age 65+.