Osteoporosis is the most common bone disease known, affecting an estimated 200 million people worldwide. Approximately 30% of all postmenopausal women are affected and up to 40% developed a fragility fracture within their lifetime. Over time, a number of risk factors have been associated with osteoporosis and are useful when used in screening tools and treatment algorithms. Diabetes, although identified more than half a century ago as being associated with bone frailty, has come to the forefront only within last decade as an important osteoporosis risk factor. While both type 1 (DM1) and type 2 (DM2) diabetes increased fracture risk, the link is far more profound with DM1. DM1 accounts for approximately 5% of all cases of diabetes in the USA and is associated with a 6.4-6.9-fold increase in the relative risk of hip fracture compared to individuals without diabetes. As life expectancy continues to increase for those living with DM1, an increase in number of fractures occurring in this population is expected in the future. For understanding of bone fragility in DM1 calls for an update of diabetes guidelines, better screening tools, and more research into the use of therapeutic strategies in these patients.