Background. With an increase in the average life expectancy and an increase in the number of people of older age groups, there is an increase in the number of patients with chronic non-communicable pathology. Type 2 diabetes mellitus is an age-related disease that is very common in today's world. This disease is associated with a high risk of complications, disability and premature death. Type 2 diabetes mellitus leads to the development of cognitive impairment, a decrease in the physical and functional activity of patients, and the progression of geriatric syndromes. Assessment of the impact of type 2 diabetes mellitus on the cognitive and functional parameters of elderly patients is actual. Aim. To assess changes in the functional and cognitive status of elderly women with type 2 diabetes on the background of modified antidiabetic therapy. Materials and methods. The longitudinal study included 80 elderly female patients with type 2 diabetes mellitus. The first group included 40 patients (mean age 68.25 ± 4.12 years) who were on traditional hypoglycemic therapy, the second group included 40 patients (mean age 68.35 ± 3.89 years) receiving enhanced hypoglycemic therapy. Cognitive and functional parameters in both groups were measured at baseline and 6 months after treatment. Results. With standard hypoglycemic therapy, the patients of the first group showed a worsening of the performance of the tandem balance test, an increase in depression, a deterioration in a number of parameters of the quality of life, according to the psychological questionnaire SF-36. The use of enhanced hypoglycemic therapy in the second group led to an improvement in the strength and function of skeletal muscles, an improvement in balance tests, a decrease in the risk of falls on the Morse scale, an improvement in cognitive functions according to the Mini-Cog and MMSE tests, a decrease in the level of depression according to the GDS-15 questionnaire, quality of life parameters according to the SF-36 questionnaire. Conclusions. With modified antidiabetic therapy for 6 months, elderly women with type 2 diabetes showed an increase in hand grip strength, improved balance, increased walking speed, reduced risk of falls on the Morse scale, improved cognitive function, reduced depression, improvement of quality of life parameters according to the SF-36 questionnaire.