Ms. Zhang accidentally broke her right foot while walking down the steps, and it didn’t hurt at that time, so she didn’t pay much attention to it and thought it would get better after a few days of rest with some medicine. However, 1 week later, she found that her right foot was getting swollen and looked a bit crooked, asymmetrical with her left foot, and she was walking awkwardly, always unable to exert herself. Ms. Zhang had to go to the hospital. After taking a medical history and performing a manual examination, the doctor highly suspected that Ms. Zhang had a combined ankle fracture with severe osteoporosis. Subsequently, Ms. Zhang’s X-ray examination results confirmed the doctor’s speculation. Ms. Zhang was surprised that she was not yet in her old age, why she was already suffering from severe osteoporosis? How did a small broken foot result in a fracture? She used to think that a fracture was painful, but why could she walk without much pain? The doctor answered each of these questions for her. It turned out that it was all due to diabetes, and Ms. Zhang is a veteran diabetic. There is an important link between blood sugar and bones. As we get older, especially at the age of 35 to 40, we start to lose bone mass, and women lose bone mass faster. Due to high blood glucose, diabetic patients will increase the filtration rate of calcium ions while the kidneys excrete too much glucose, and at the same time lose magnesium and phosphorus in the bones, which will lead to a decrease in inorganic salt components such as calcium, magnesium and phosphorus in the bones, thus decreasing bone mass. Meanwhile, insulin secretion is insufficient in diabetic patients, and insulin has the function of promoting bone matrix and collagen synthesis. Insufficient bone matrix and collagen synthesis increases the brittleness of bones, thus increasing the risk of fracture. In addition, diabetic patients tend to have obesity and reduced physical activity, and bones may also suffer from decreased bone mass due to insufficient strength stimulation. Therefore, in today’s increasing number of diabetic patients, the invisible killer of osteoporosis comes along with it. Although the force of a broken foot is small, the metabolic disorders of diabetic patients lead to a decrease in body muscle strength, and good muscle strength can maintain body balance while acting as an unloading cushion to protect bones and joints in case of a fall. This self-protective ability of diabetic patients becomes poor, and they are prone to falls and fractures. More seriously, diabetes can cause peripheral neuropathy. It is mainly caused by the production of many toxic substances, such as fructose, in the body after a long period of high blood sugar. These substances affect the functional state of the nerve cells, and the more prominent clinical manifestation is the bilateral symmetrical hyperalgesia of the limbs. In fact, pain is a very important self-protection mechanism of the body. When nociception is reduced, the body ignores the presence of the injury because pain perception is not obvious. Continued activity without protection will lead to increased injury and delayed healing of soft tissues and bones. It is because of the above reasons that Ms. Zhang developed a serious fracture under a minor external force and did not receive timely treatment. Therefore, diabetic patients must pay attention to early detection of blood sugar abnormalities and scientific blood sugar management to reduce complications. At the same time, pay attention to calcium supplementation, increase activity to improve bone quality, and seek timely medical attention for injuries that occur during activity so as not to miss the best time for treatment.