Hyperglycaemia is an under-appreciated but modifiable risk factor in managing people with type 1 diabetes and fragility fractures.

• T1DM significantly increases risk of fragility fracture and bony non-union. • Glycaemic control is a significant but modifiable risk factor in treating fractures in T1DM. • Intensive glycaemic levels should be targeted to reduce complications. There are two major musculoskeletal effects of Type 1 diabetes mellitus (T1DM) — fragility fractures and impaired fracture union. Fractures in these patients are a significant and limb threatening injury. Traditionally, they have been treated with prolonged immobilisation and as rigid as possible internal fixation. Recently, hyperglycaemia has been recognised as the most significant modifiable risk factor in treating patients with T1DM and fractured limbs. This article reviews this association further and outlines the role of orthopaedic surgeons in minimising orthopaedic-related complications. [ABSTRACT FROM AUTHOR]