This article argues the essence of insulin sensitivity versus secretion including insulin resistance in the clinical strategy for the treatment, lifestyle changes, prompt interventions and control of diabetes. Progressive decline of glucose tolerance as advanced age occurs has been associated with the pathogenesis of type 2 diabetes due to peripheral insulin resistance and impaired β cell function. In elderly persons, insulin secretion is deranged concomitantly with decreased insulin clearance rate and augmented circulating proinsulin level that ostensibly explicates age-related hyperglycemia. Insulin is associated with numerous pathophysiological processes exhibited during brain function in learning and memory, as well as the regulation of ageing, metabolic syndrome, obesity, diabetes and cardiovascular diseases in Man. Elevated chronic peripheral insulin, decreased insulin action and brain insulin contents are pathognomonic of the insulin resistance syndrome. All these are associated through specific mechanisms in the pathophysiology of ageing and insulin in concert with risk factors and the concomitant complications. Ostensibly, progressive excess insulin induces synchronous elevated levels of oxidative stress and inflammatory impacts which exacerbate or are exacerbated by advancing age, culminating as inimical consequences to healthy lifestyles, longevity or extended lifespan. Therapeutics and other healthcare measures may be beneficial in order to prevent, mitigate or amend insulin aberrations in the elderly and during the ageing process. The mainstay in managing an elderly patient with perturbed insulin action, is control of therapeutic application, as it can reverse acute terminal states. Treatment necessitates stringent and thorough expertise, knowledge and skills for optimum provision and effective cerebral, cardiovascular and skeletal protection for a healthier lifespan and longevity. This article will be of immense contribution in the understanding of the prevention, control and treatment of insulin resistance, metabolic syndrome, diabetes, obesity, cardiovascular and neurological disorders during ageing.