OBJECTIVE -Individuals with diabetes pay increased premiums and experience limited coverage when taking out accident insurance, despite the lack of scientific support for this practice. The aim of the present study was to analyze whether diabetic individuals have an increased risk of accidents or an increased risk of permanent disability after an accident, compared with two nondiabetic groups. RESEARCH DESIGN AND METHODS- All diabetic members of the Danish Diabetes Association were given free accident insurance for a 3-year period. Based on informed consent, they were also asked to participate in a follow-up study, comparing accident rates in diabetic individuals with a nondiabetic group. A total of 7, 599 diabetic members accepted. The control groups were 1 ) individuals with a leisure-time insurance in the same company (individual issue) and 2) members of full-time group-based insurance (bank employees) in the same company RESULTS -The risk of accidents was 0.7 per 1, 000 person-years in the diabetic group, compared with 4.5 per 1, 000 person-years in the first and 5.5 per 1, 000 person-years in the second nondiabetic control group (P < 0.001). The degree of permanent injury did not differ between the diabetic and the nondiabetic group. CONCLUSIONS -The risk of accidents and permanent disability is not increased in diabetic individuals. Thus, diabetic individuals should be offered accident insurance at a standard premium without limited coverage.