The purpose of the ACCORD-BONE Study is to investigate the effects of intensive glycemic control for type 2 diabetes (in ACCORD participants) on factors related to bone health, including, fractures, falls, and bone mineral density. The primary objective of the study is to determine if intensive glycemic control compared to standard glycemic control will have a lower rate of non-vertebral fractures and will result in less falls. Secondary objectives include evaluations between the intensive and standard intervention groups, for differences in height loss and bone mineral density. Approximately 7,145 ACCORD participants will have all fracture and fall measures collected throughout the trial. In addition, 130 participants will have bone mineral density measures every other year.

Recent studies have established that type 2 diabetes is a risk factor for fractures, particularly of the hip, shoulder and foot. Additionally, type 2 diabetes is associated with a 50-60% increase in the risk of falling. The higher risk of fracture associated with type 2 diabetes is an important health burden for these patients. More frequent falls and perhaps reduced bone strength in those with diabetes are thought to be key contributing factors. The best approach to preventing fractures in type 2 diabetes is not yet understood. There is observational evidence to support our hypothesis that better glycemic control will preserve bone and reduce falls and fractures. The ACCORD-BONE study provides a unique opportunity to determine whether intensive glycemic control will prevent fractures, falls, and bone loss in older diabetic adults, which may lead to improved treatment and prevention in the future.