Patients with type 1 diabetes who have good glycemic control still have about twice the mortality risk as the general population, according to a case-control study in the New England Journal of Medicine.

Using Swedish registries, researchers matched 34,000 adults with type 1 diabetes to roughly 170,000 adults without type 1 diabetes (mean age, 36). All patients with diabetes were at elevated risk for all-cause mortality, even those with well-controlled mean glycated hemoglobin levels (5.4% for patients with hemoglobin A1c levels of 6.9% or below vs. 2.9% mortality rate for controls during 8 years’ follow-up). In that same period, mortality increased with increasing levels of glycated hemoglobin (12% for HbA1c of 9.7% or higher).

There were similar trends in cardiovascular and diabetes mortality, which accounted for much of the excess overall mortality risk.