It is well-documented that diabetes plays a significant role in contributing to the growth of blood cancer termed as multiple myeloma. Various studies had underlined the fact that when compared to individuals of different racial backgrounds, patients with diabetes and myeloma from certain demographics had varying rates of survival. A recent study published in the journal 'Blood Advances' explored, for the first time, the relationship between racial differences and survival in people with diabetes with multiple myeloma.

      In this retrospective study the researchers examined the electronic health records of more than 5,300 patients with multiple myeloma. Fifteen percent had a diabetes diagnosis, including 12% of patients from one demographic and 25% from another. Multivariable Cox models showed reduced overall survival (OS) for patients with diabetes (HR 1.27; 95% CI 1.11, 1.47; p<0.001) and this was observed in patients from both demographics, though there were notable differences. However, obesity was associated with better OS in one demographic, but not the other.

      To substantiate the findings, and to evaluate the mechanisms linking diabetes and multiple myeloma, the research team assessed multiple myeloma growth in a genetically engineered immunocompromised non-obese diabetic (Rag1-/-/MKR) mouse model. Western blot analysis found that MM1.S xenografts from Rag1-/-/MKR mice had higher phospho-S6 ribosomal protein(Ser235/236) levels indicating greater activation of the mammalian target of rapamycin pathway.

      The results put forth the conclusion that diabetes may contribute to the higher incidence of multiple myeloma in certain patient demographics, and to improve survival in multiple myeloma, diabetes management is essentially required. The researchers hope that these findings will throw insights into the novel therapies that may halt the development of multiple myeloma and the overactive insulin signaling pathway in patients with multiple myeloma and diabetes.