Insulin Therapy Tied to Increased Death Risk for Multiple Myeloma Patients

Specialty Pharmacy Times, July/August 2014, Volume 5, Issue 4

Multiple myeloma patients who use insulin to treat diabetes may be at an increased risk for poor outcomes, according to the results of a recent study.

The retrospective review, published online on June 12, 2014, in the British Journal of Cancer, analyzed the effect of diabetes and diabetic medication on outcomes for 1240 multiple myeloma patients. The researchers of the study hypothesized that insulin or insulin-like growth factor-1 signaling may underlie the promoting effect of type 2 diabetes on cancer.

Overall, multiple myeloma patients with diabetes had significantly shorter survival times than those without diabetes. The median survival time for patients with diabetes was 65.4 months compared with 98.7 months among patients without diabetes. Steroid-induced diabetes increased the risk for a shortened survival time, as did age, comorbidities, multiple myeloma stage, and cytogenetic abnormalities. Among patients with diabetes, treatment with metformin was associated with an increased survival time, while use of insulin or analogues was associated with an increased cumulative incidence of death with progressive multiple myeloma.

“No conclusion about causal relationships can be made at this time,” the study authors wrote. “Managing hyperglycaemia with non-insulin regimens should be investigated in randomized trials.”