The majority of patients with diabetes are elderly, but little is known about their disease management. This study evaluates the prevalence and correlates of treatment of elderly diabetics residing in long-term care. We performed a retrospective, cross-sectional study of 75,829 elderly diabetics residing in nursing homes from 1992 to 1996. Nearly half (47%) of the residents received no antidiabetic medications. Independent predictors not receiving antidiabetic medications included age, race, impaired physical ability, and impaired cognitive function. Although the absence of resident's blood glucose or glycosylated hemoglobin (HbA1c) values prevents us from passing judgment about the adequacy of diabetic care, further research is needed to understand why some residents do not receive antidiabetic medications in the long-term care setting.