It is well known that diabetes can lead to a variety of metabolic abnormalities. There are not only disorders of sugar, protein and fat metabolism, but also negative balance of calcium metabolism and abnormal bone metabolism. Diabetic osteoporosis is a serious complication of diabetes mellitus in the skeletal system and is a peripheral skeletal disease characterized by a decrease in bone mass or destruction of bone tissue structure. As the prevalence of diabetes increases year by year, diabetic osteoporosis has become one of the main reasons for the decline in the quality of life of diabetic patients and one of the diseases with the highest disability rate, which has received increasing attention in recent years. Compared with the general population, the incidence of osteoporosis and the risk of osteoporotic fracture are significantly increased in patients with type 1 diabetes.The effect of type 2 diabetes on bone mass and bone mineral density is still lacking consistent conclusions, and different clinical studies have found that bone mass in diabetic patients can be shown to be reduced, normal or unchanged, but the overall fracture risk is increasing. Diabetic patients have insufficient insulin secretion, resulting in decreased bone matrix maturation and conversion, loss of bone minerals, decreased active vitamin D synthesis, decreased intestinal absorption of calcium and phosphorus, increased urinary calcium excretion, and bone calcium mobilization leading to osteoporosis. When diabetic patients have poor blood sugar control, high blood sugar leads to polyuria, which increases urinary calcium and phosphorus excretion and enhances bone resorption. High urine glucose also hinders the reabsorption of calcium, phosphorus and magnesium by the kidney, which increases bone salt loss. Many studies have shown that microvascular and macrovascular lesions caused by long-term poor glycemic control are responsible for bone loss and increased bone fragility. These include retinopathy, peripheral neuropathy, nephropathy and peripheral vascular disease. When diabetes is complicated by microangiopathy, it can affect the vascular distribution of bone, resulting in insufficient blood supply and hypoxia to the bone tissue and causing abnormal bone metabolism. The combination of diabetes mellitus with decreased vision and reduced neurological control is also a risk factor for fracture. In addition, the factors influencing the development of diabetic osteoporosis are also related to gender, age, race, exercise, lifestyle, nutritional status, weight, living conditions, duration of diabetes, genetics and other factors. Some people call osteoporosis a “silent epidemic” because it occurs unconsciously, and the early symptoms are mild, even without any feeling. Fracture: Fracture is the most serious consequence of osteoporosis, and is often the first symptom and reason for some osteoporosis patients to visit the doctor. After fracture of the spine and lower limbs, the elderly are bedridden for a long time, which can induce a variety of complications, such as bedsores, urinary stones, cerebral thrombosis, pneumonia, etc., seriously affecting health and threatening life. 2. Shortening of height and hunchback: early bone loss and compression fracture may lead to shortening of height or hunchback deformity. 3. Pain: Most people feel back pain, followed by shoulder and back, neck, wrist and ankle pain, and general weakness. The pain is widespread and may vary, independent of the position of sitting, lying, standing or turning, etc. The symptoms are sometimes mild and sometimes severe. How to diagnose osteoporosis Bone densitometry is currently the best quantitative index for diagnosing osteoporosis, predicting the risk of osteoporotic fracture, monitoring the natural course of the disease and evaluating the efficacy of drug interventions. Dual-energy X-ray absorptiometry is the currently accepted method of bone densitometry and is the gold standard for diagnosing osteoporosis. It is usually expressed as T-Score (T-value), i.e. T-value ≥ -1.0 is normal, -2.5 < T-value < -1.0 is bone loss, T-value £ -2.5 is osteoporosis. Severe osteoporosis is considered when the degree of bone density reduction meets the diagnostic criteria for osteoporosis and is accompanied by one or more fractures. Bone densitometry by dual-energy x-ray absorptiometry costs 120 RMB per test, and is a non-invasive test that requires no fasting or other special preparation. For patients suffering from diabetes, it is better to evaluate the risk factors of osteoporosis and then have the bone density measurement, many hospitals have osteoporosis clinic, patients can register for this test. Fourth, who needs to measure bone density? 1.Women over 65 years old and men over 70 years old without other risk factors for osteoporosis; 2.Women under 65 years old and men under 70 years old with one or more risk factors for osteoporosis; 3.Adults of both sexes with a history of fragility fracture or/and family history of fragility fracture; 4.Adults of both sexes with low sex hormone levels due to various reasons; 5.Patients with osteoporotic changes on X-ray; 6.Patients receiving osteoporosis treatment for osteoporosis 6. Those who have received osteoporosis treatment for efficacy monitoring; 7. Those who have a history of diseases and drugs affecting bone mineral metabolism. In view of the fact that diabetes is a high-risk group for osteoporotic fracture, diabetic patients should pay attention to their bone health. Once osteoporotic fractures occur, the quality of life decreases and various complications occur, which can be disabling or fatal, so prevention of osteoporosis is more realistic and important than treatment. Moreover, osteoporosis can be prevented. Basic measures include calcium and vitamin D supplementation, regular exercise, appropriate light exposure (at least half an hour a day), smoking cessation, and careful use of drugs that affect bone metabolism. Regular exercise is not only beneficial for diabetic patients in terms of blood glucose and weight control, but also for healthy bone reconstruction, maintaining balance and muscle coordination, and avoiding falls. Measures to prevent falls include increasing muscle strength and balance, assessment of home hazards (e.g., use of lights), avoidance of hypoglycemia and severe hypoglycemia, discontinuation of antipsychotic medications, vision testing, cataract surgery, and use of hip protectors. Strict glycemic control in diabetic patients can help prevent osteoporosis. For diabetic patients with osteoporosis or fragility fractures, or those with reduced bone mass and risk factors for osteoporosis, treatment for osteoporosis should be started. Bone density can be measured half a year to one year to monitor the progress of the disease and evaluate the efficacy of drugs.