Type 2 Diabetes Prevention May Reduce the Risk of Diffuse Large B-cell Lymphoma and Multiple Myeloma

Key Takeaways:

• Type 2 diabetes (T2D) appears to increase the risk of diffuse large B-cell lymphoma (DLBCL) and multiple myeloma (MM). Patients with T2D had a 15% higher risk of DLBCL and a 20% higher risk of MM than patients without T2D.
• T2D may lower the risk for T-cell non-Hodgkin lymphoma (T-NHL), lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM), and mycosis fungoides/Sézary syndrome (MF/SS). Patients with T2D had a 55% reduced risk of LPL/WM, a 22% lower risk of T-NHL, and a 33% lower risk of MF/SS.
• The risk of DLBCL was higher in patients with over 5 years of T2D, and the risk of MM was highest in patients with less than 10 years of T2D. Conversely, the risk of T-NHL was lowest for patients with over 10 years of T2D.

Previous studies have demonstrated an association between T2D and NHL. Additionally, many patients with MM are also diagnosed with T2D. A pooled study sought to observe any associations between T2D and NHL and MM.

The study pooled data from 5 studies: the Cancer Prevention Study-II Nutrition Cohort, California Teachers’ Study, Health Professionals Follow-Up Study, Nurses’ Health Study (NHS), and NHSII. A sample from the Kaiser Permanente Southern California member cohort was also included. A total of 585 114 patients were included in the study.

Differing Lymphoma Risks in Patients With T2D

The study did not support prior studies by finding a link between T2D and NHL. Instead, T2D was positively associated with the risk of DLBCL. Patients with T2D had a 15% higher risk of DLBCL and a 20% higher risk of MM than patients without T2D.

The study also unexpectedly found inverse associations between T2D and LPL/WM, T-NHL, and MF/SS. T2D led to a 55% reduced risk of LPL/WM, a 22% lower risk of T-NHL, and a 33% lower risk of MF/SS. More research is needed to explain these findings.

Patients with T2D for over 5 years had a 34% increased risk of DLBCL as well as a higher risk of NHL. The risk of MM was also increased within the first 10 years of a T2D diagnosis.

Patients with over 10 years of T2D had the lowest risk of T-NHL, another example of the inverse association observed between the disease states.

Implications for Long-Term T2D Management and Cancer Risk

The results of the study differ from those of previous studies which found an increased risk of NHL in patients with T2D. Instead, a positive association between T2D and DLBCL was observed. Furthermore, an inverse association between T2D and LPL/WM, T-NHL, and MF/SS was found. More research is required to validate and understand these results.

The authors said, “These findings suggest that T2D prevention, independent of BMI, may be important in strategies to reduce MM and DLBCL incidence. The unexpected inverse associations for T-NHL, MF/SS, and LPL/WM should be interpreted with caution, given the small numbers of ‘exposed’ cases and the lack of plausible biological mechanisms to explain them.”

Reference

Korat AVA, Deubler EL, Bertrand KA, et al. T2D and risk of non-Hodgkin lymphoma and multiple myeloma: a pooled analysis. JNCI Cancer Spectrum. 2026;10(2):pkag017. doi:10.1093/jncics/pkag017