Title:The Interactions Between Diabetes Mellitus and Myelodysplastic Syndromes: Current State of Evidence and Future Directions
VOLUME: 12 ISSUE: 3
Author(s):Eyad Hamoudeh, Amer M. Zeidan, Lisa Barbarotta and Nina Rosano
Affiliation:Section of Hematology, Department of Internal Medicine, Yale University, 333 Cedar Street, PO Box 208028, New Haven, CT 06520-8028.
Keywords:Diabetes mellitus (DM), myelodysplastic syndromes (MDS), hyperglycemia, insulin resistance.
Abstract:Diabetes mellitus (DM) and cancer are disorders of global importance. Multiple epidemiologic
studies show that diabetic patients have an increased risk of developing cancer of different
types. Myelodysplastic syndromes (MDS) are among the most common hematologic malignancies and
include a heterogeneous group of hematopoietic neoplasms characterized by dysplastic changes, low
blood counts, and an increased risk of progression to acute myeloid leukemia. Potential epigenetic and
metabolic interferences between DM and MDS have been reported but are poorly understood. DM and
MDS share some predisposing risk factors such as obesity. Patients with MDS and DM can experience worsening of diabetic
control due to multiple factors that exacerbate hyperglycemia and insulin resistance such as stress, infections, adjunct
drugs (e.g. steroids to control nausea), and others. In addition, accurate assessment of glucose control in diabetic patients
who have MDS can be complicated. Alternatively, DM when associated with end-organ damage can complicate
management of MDS, increase risks of complications, and limit the applicability of intensive therapeutic interventions.
Here we review the current knowledge of the interactions between DM and MDS at the pathogenetic, clinical and epidemiologic
levels, discuss how this knowledge could be used therapeutically to improve the outcome of patients affected by
both conditions, and delineate important unmet needs that should be addressed in future research.
