Objective: Growing evidences shows that fasting glucose target should be different according to their health condition in older adults with diabetes. However, there are limited data regarding the relationship between fasting glucose level and health outcomes in Korean older people with diabetes. We aimed to examine the association of fasting glucose with mortality and cardiovascular events in in Korean older adults with type 2 diabetes. Methods: We identified 227,938 aged 65 years and older type 2 diabetes subjects without a history of MI and stroke who underwent >_2 health examinations from 2009 to 2010 and were followed up until 2017 in the Korean National Health Insurance System cohort. Our primary exposure variable was mean fasting glucose level from 2009-2010. Comorbidity load in individuals were assessed by Charlson comorbidity index. Results: The data showed a J-shaped distribution for all-cause mortality and CV events regardless of sex, age and number of comorbidities. Fasting glucose levels associated with the lowest mortality were 110-124mg/dL and the lowest CV events were 90-124 mg/dL, respectively. Stratified analysis by Charlson comorbidity index (CCI) revealed that optimal fasting glucose levels for lowest cardiovascular events were higher in subjects with higher CCI than lower CCI (~80-139 mg/dL vs. 95-139 mg/dL, P for interaction = 0.047). Conclusion: J shaped relationship exists between fasting glucose and all-cause mortality and CV event in Korean older diabetic patients. The optimal fasting glucose rage for the lowest all-cause mortality and CV events were 110-124 and 95-110 mg/dL, respectively. The dramatic increase of the CV event risk in too low level of fasting glucose (less than 95 mg/dL) were noted in patients with high comorbidity. This finding suggest that more stringent targets for fasting glucose are associated with increased adverse health outcome especially in older adults with many comorbidities.