Trends in mortality from multiple myeloma and diabetes mellitus in the United States: A retrospective analysis from 1999 to 2020

Abstract Background: Diabetes mellitus has been associated with an increased risk of multiple myeloma. This has been supported by multiple epidemiological studies. The main purpose of study was to analyze the trends in mortality from multiple myeloma in patients with diabetes mellitus. Method: We used ICD-10 codes to identify deaths from multiple myeloma in diabetic patients from 1999 to 2020. The age-adjusted mortality rates were extracted, and trends were analyzed for gender, race and year. Result: There were a total of 18411 deaths from multiple myeloma from 1999 to 2020 in patients with diabetes. The mean AAMR from multiple myeloma for diabetic males (0.527 per 100,000; 95% CI: 0.500–0.554) was higher than diabetic females (0.280 per 100,000; 95% CI: 0.269–0.290). Linear regression analysis revealed an increase in AAMR among diabetic males over the course of study period (β = 0.0066, p < 0.001). But no significant change was noted among diabetic females (β = –0.0008, p = 0.298). Race analysis showed that African American patients with diabetes have significantly higher AAMR from multiple myeloma as compared to any other race. In fact, the mean AAMR for African Americans was 1.009 (range: 0.967–1.051; SD: 0.101), which is 3 times higher as compared to Whites (mean: 0.317; range: 0.303–0.330; SD: 0.031), who have the second highest AAMR. No significant change in mortality from multiple myeloma was noted in diabetic African Americans over the study period (p = 0.727) with slight upward trend noted in diabetic whites (p = 0.039). Discussion: Our study tends to support the evidence base that diabetes mellitus is associated with worse overall survival in patients with multiple myeloma. Multiple studies have demonstrated decreasing mortality trends from multiple myeloma in most of the population subgroups. But our study demonstrates that there is no significant decrease in mortality from multiple myeloma in diabetic patients. If anything, a modest increase in mortality has been noted among certain subgroups in this cohort. Further research is needed to study the pathophysiological mechanisms responsible for worse overall survival in diabetic patients with multiple myeloma.