Patients with type 2 diabetes mellitus (DM2) are recognised to have a higher risk of fragility fractures. With the increasing prevalence of DM2 in Singapore and an ageing population, the impact of DM2 on fragility fracture is expected to rise. The aim of this article is to review updated information on bone fragility and fracture risk in DM2 patients, to discuss the impact of diabetes treatment on bone metabolism, as well as the efficacy of anti-osteoporosis treatments for this population. An algorithm is proposed for the identification and management of DM2 patients at increased fracture risk.