OBJECTIVES: We performed a retrospective data analysis to examine the use of medications that can cause hypoglycaemia in elderly diabetes mellitus patients in Malaysia. METHODS: We utilised data from the National Diabetes Registry from 2012 containing data from diabetes patients followed up in Malaysian public sector primary care clinics. Medications analysed were anti-diabetic (metformin, sulphonylurea, acarbose, insulin) and anti-hypertensive drugs classes (ACE-inhibitors, beta-blockers) which were widely used in the study population. Descriptive and univariate analyses were performed to examine the use of these medications across various age groups. RESULTS: A total of 130,246 patients with T2DM were included in the study. The patients were divided into 4 age groups, with 8.4% under 45 years old, 58.3% aged between 45–64 years, 29.8% between 65-79 years old and 3.5% over 80 years of age. The mean HbA of patients in the <45 years age group was the highest at 8.68%  and lowest in the ≥80 years age group at 7.11%. There were significant reductions in the use of metformin (from 83.97% to 68.69% of patients) and insulin (24.70% to 12.03%) with age (all P<0.001). However, sulphonylurea use was similar cross all age groups (52.55% to 57.44%, P=0.500) while use of acarbose was generally higher in older patients (3.12% to 3.94%, P<0.001). In the subset of diabetics with hypertension, use of ACE inhibitors declined with age (64.43% to 49.95%, P<0.001) while use of beta blockers increased with age (20.11% to 35.56%, P<0.001). CONCLUSIONS: Despite limitations of our study especially related to reasons for prescribing different drugs, we note that a large proportion of older patients are still prescribed with medications that potentially cause hypoglycaemia, in particular, sulphonylureas and beta-blockers. This finding is to remind doctors to proceed with caution in treating the elderly when treating the elderly with certain medications.