Diabetes mellitus: How being too sweet leads to skeletal fragility

Abstract Diabetes mellitus increases fracture risk. Chronic hyperglycemia causes maladaptations which directly influence bone material properties and affect skeletal integrity. The microvascular complications of diabetes: retinopathy, neuropathy and nephropathy also affect bone indirectly by increasing fall risk and affecting calcium metabolism. In this chapter we will discuss the available evidence in human studies which can inform clinical decision making for diabetic patients with skeletal fragility.