Diabetes is a condition where multiple risk factors must be controlled to prevent and treat vascular disease. Polypharmacy is therefore an inevitable consequence of treating diabetes, particularly for the older patient for whom the risk of a fatal vascular event is far greater. The older diabetes patient is also more likely to have coexistent conditions that need treating. This article describes the level of polypharmacy in patients with diabetes who are ≥ 70 years in one general practice. These patients were taking a mean of four cardio-diabetes medications (three for vascular disease/risk factors and one for diabetes). In addition to their cardio-diabetes medications, the average patient was also taking three medications for co-existent conditions.