Trial reportDiabetes care2012
Intensive glycemic control is not associated with fractures or falls in the ACCORD randomized trial.
Trial report in Diabetes care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00324350 (Intensive Glycemic Control and Skeletal Health Study - Ancillary Study to the Action to Control Cardiovascular Risk in Diabetes Trial), which is not on this map. Cited by 58 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Intensive Glycemic Control and Skeletal Health Study - Ancillary Study to the Action to Control Cardiovascular Risk in Diabetes Trial (ACCORD-BONE)
Who cites it
58 citing papers in PubMed, 3 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- Influence of glycemic control and hypoglycemia on the risk of fracture in patients with diabetes mellitus: a systematic review and meta-analysis of observational studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Pooled it
- Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2019Guideline
- Type 1 diabetes and risk of fracture: meta-analysis and review of the literature.Diabetic medicine : a journal of the British Diabetic Association · 2015Pooled it
- Baseline serum metabolites predict fractures in individuals who were Black and had type 2 diabetes.Frontiers in endocrinology · 2026Trial
- Predictors of Fracture in Middle-Aged and Older Adults With Type 2 Diabetes and Overweight or Obesity.The Journal of clinical endocrinology and metabolism · 2025Trial
- Effect of a Multifactorial Intervention on Fracture in Patients With Type 2 Diabetes: Subanalysis of the J-DOIT3 Study.The Journal of clinical endocrinology and metabolism · 2021Trial
- Hemoglobin A1c Threshold for Reduction in Bone Turnover in Men With Type 2 Diabetes Mellitus.Frontiers in endocrinology · 2021Trial
- Intensive blood pressure control, falls, and fractures in patients with type 2 diabetes: the ACCORD trial.Journal of general internal medicine · 2014Trial
- Effects of randomization to intensive glucose control on adverse events, cardiovascular disease, and mortality in older versus younger adults in the ACCORD Trial.Diabetes care · 2014Trial
- Intensive glycemic control and thiazolidinedione use: effects on cortical and trabecular bone at the radius and tibia.Calcified tissue international · 2013Trial
- Brazilian guidelines for the management of osteoporosis in diabetes mellitus.Diabetology & metabolic syndrome · 2025Review
- Sex differences in association of joint glycemic, blood pressure and lipid control and two-year risk of falls among older adults with diabetes.Journal of diabetes and its complications · 2024Article
- Obesity and Skeletal Fragility.The Journal of clinical endocrinology and metabolism · 2024Review
- Risk of fracture according to temporal changes of low body weight changes in adults over 40 years: a nationwide population-based cohort study.BMC public health · 2023Article
- Underweight and risk of fractures in adults over 40 years using the nationwide claims database.Scientific reports · 2023Article
- Musculoskeletal complications in patients with diabetes mellitus.The Korean journal of internal medicine · 2022Review
- The association of glycemic control and fall risk in diabetic elderly: a cross-sectional study in Hong Kong.BMC primary care · 2022Article
- Changes in Underweight Status and Risk of Hip Fracture: A Korean Nationwide Population-Based Cohort Study.Journal of clinical medicine · 2022Article
- Unmasking Fracture Risk in Type 2 Diabetes: The Association of Longitudinal Glycemic Hemoglobin Level and Medications.The Journal of clinical endocrinology and metabolism · 2022Article
- Comparison of fracture risk between type 1 and type 2 diabetes: a comprehensive real-world data.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 11 institutions in 2 countries.
Funding
Abstract
objectiveOlder adults with type 2 diabetes are at high risk of fractures and falls, but the effect of glycemic control on these outcomes is unknown. To determine the effect of intensive versus standard glycemic control, we assessed fractures and falls as outcomes in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) randomized trial. RESEARCH DESIGN AND
methodsACCORD participants were randomized to intensive or standard glycemia strategies, with an achieved median A1C of 6.4 and 7.5%, respectively. In the ACCORD BONE ancillary study, fractures were assessed at 54 of the 77 ACCORD clinical sites that included 7,287 of the 10,251 ACCORD participants. At annual visits, 6,782 participants were asked about falls in the previous year.
resultsDuring an average follow-up of 3.8 (SD 1.3) years, 198 of 3,655 participants in the intensive glycemia and 189 of 3,632 participants in the standard glycemia group experienced at least one nonspine fracture. The average rate of first nonspine fracture was 13.9 and 13.3 per 1,000 person-years in the intensive and standard groups, respectively (hazard ratio 1.04 [95% CI 0.86-1.27]). During an average follow-up of 2.0 years, 1,122 of 3,364 intensive- and 1,133 of 3,418 standard-therapy participants reported at least one fall. The average rate of falls was 60.8 and 55.3 per 100 person-years in the intensive and standard glycemia groups, respectively (1.10 [0.84-1.43]).
conclusionsCompared with standard glycemia, intensive glycemia did not increase or decrease fracture or fall risk in ACCORD.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.