The risk of fracture is increased in patients with type 1 and type 2 diabetes. Bone mineral density (BMD) tends to be decreased in type 1 diabetes and increased in type 2 diabetes. BMD and the fracture risk assessment tool (FRAX) underestimate the fracture risk in patients with type 2 diabetes, and specific adjustments may be required. Poor glycemic control is the main fracture risk predictor. Conventional treatments for osteoporosis have not been specifically evaluated in non-osteoporotic diabetic patients. However, they can be prescribed to diabetics at high risk for fractures if there are no contraindications. Preventing the risk of falls and optimizing muscle health are essential in older diabetic patients.