First Department of Propaedeutic Internal Medicine and Diabetes Center, School of Medicine, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece.
Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece.
Diabetes Metab Res Rev. 2022 Jul;38(5):e3535. doi: 10.1002/dmrr.3535. Epub 2022 May 25.
Diabetes mellitus (DM) has attained the status of a global pandemic. Cardiovascular disease (CV) was the leading cause of morbidity in people with type 2 DM, however, a transition from CV to cancer as the leading contributor to DM related death has been observed lately. Multiple myeloma (MM) is the second most common haematological malignancy. Obesity is a common risk factor for both DM and MM. Although data are limited, studies have shown that DM might be associated with increased risk for the development of MM. The presence of DM might affect the course of patients with MM, since hyperglycemia may have an impact on both the efficacy and the adverse effects of antimyeloma therapy. In parallel, DM and MM share common clinical presentations, such as nephropathy, neuropathy, and CV. In terms of antidiabetic medications, metformin might present a synergistic effect with antimyeloma drugs and also prevent some of the adverse effects of these drugs; pioglitazone might have favourable effects when given as add on treatment in people with relapsed or refractory MM. No clinically important interactions have been observed between antidiabetic agents and the most commonly used antimyeloma drugs. Further data are needed to examine the effect of all classes of antidiabetic medication on MM and its complications. A baseline assessment of risk factors for glucose intolerance and close monitoring of glucose levels during therapy is strongly suggested for patients with MM.
糖尿病（DM）已成为全球性的大流行病。心血管疾病（CV）是 2 型糖尿病患者发病率的主要原因，但最近观察到，CV 已转变为癌症，成为导致 DM 相关死亡的主要原因。多发性骨髓瘤（MM）是第二常见的血液系统恶性肿瘤。肥胖是 DM 和 MM 的共同危险因素。尽管数据有限，但研究表明，DM 可能与 MM 发病风险增加有关。DM 的存在可能会影响 MM 患者的病程，因为高血糖可能会对骨髓瘤治疗的疗效和不良反应产生影响。同时，DM 和 MM 具有共同的临床表现，如肾病、神经病变和 CV。在降糖药物方面，二甲双胍可能与骨髓瘤药物具有协同作用，并能预防这些药物的一些不良反应；对于复发或难治性 MM 患者，加用吡格列酮可能会有有利影响。尚未观察到降糖药物与最常用的骨髓瘤药物之间存在临床相关的相互作用。需要进一步的数据来研究所有类别的降糖药物对 MM 及其并发症的影响。建议对 MM 患者进行血糖耐受不良危险因素的基线评估，并在治疗期间密切监测血糖水平。
