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Play the video to watch Professor Thomas Danne discussing inadequate glycaemic control and mortality
Now, just to appreciate what it really means in terms of glycaemic control, again we’re looking at Swedish Registry data. And if you look at targets, we recommend the target of being below A1c of 7% in order to really be in target. But if you look at the registry data, you see that cardiovascular mortality is still elevated, even if you meet this target. If you move on to higher A1cs – and we know that unfortunately, during adolescence and young adulthood, many people are not able to achieve this target – we see that cardiovascular mortality is increasing. So, even though people are improving in their quality of glycaemic control, they still face a high risk of cardiovascular mortality, indicating again unmet need, because we’re not reaching those targets of near normal life expectancy with current therapies.
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n=33,915 (T1D), 169,249 (matched controls); mean follow-up 8.0 years (T1D) and 8.3 years (control); HR of controls (reference), 1.0.
Cox regression analysis, adjusted for time-updated age, sex, time-updated duration of diabetes, birth in Sweden or elsewhere, educational level, and status with respect to a history of conditions other than diabetes at baseline. “Time-updated” is defined as the recorded value closest to the time of each event.

CI: confidence interval;
CV: cardiovascular;
HbA1c: glycated haemoglobin
HR: hazard ratio
T1D: type 1 diabetes

Lind M, Svensson AM, Kosiborod M, Gudbjörnsdottir S, Pivodic A, Wedel H, Dahlqvist S, Clements M, Rosengren A. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014 Nov 20;371(21):1972-82