Diabetes in the elderly can cause spontaneous fractures. The reason for this is that poorly controlled diabetes causes osteoporosis, which makes certain parts of the bone so brittle that the slightest movement such as getting out of bed, going down stairs, or even coughing can cause a fracture, which is also known as a “spontaneous fracture”. The mechanism of diabetic osteoporosis involves several aspects, among which the main factor is that, due to the continuous increase of blood sugar and poor control, glucose excretion from urine increases and causes osmotic diuresis, resulting in a large loss of calcium, phosphorus, magnesium and other minerals, and the loss of calcium stimulates the secretion of thyroxine, which enhances osteolysis and significantly reduces bone mass, which is the basic cause of diabetic osteoporosis. Secondly, the lack of insulin and insufficient secretion caused by diabetes can lead to impaired bone formation and transformation, causing a decrease in bone density and an increase in the degree of osteoporosis. In addition, reduced outdoor activities in the elderly, decreased estrogen levels in older women, aging and various complications of diabetes such as microangiopathy, neuropathy and nephropathy are also contributing factors to diabetic osteoporosis. Therefore, diabetic osteoporosis mostly occurs in elderly patients with long medical history, poor glycemic control and many complications. Fractures caused by diabetic osteoporosis occur mostly in the femoral neck, followed by the femoral stem, tibia and lumbar vertebrae. Compared with the general population, fractures caused by diabetes are mostly spontaneous, and a slight external force can cause fractures to occur, and the healing rate is very slow, with a high incidence of disability, which seriously reduces the quality of life of elderly patients.