**4.11 Diabetes**

Comorbidities present in NDMM patients play a strong role in what therapies may be available [70]. Diabetes mellitus, owing to concomitant progressive renal dysfunction and peripheral neuropathy, may limit the use or dose of certain novel therapies. Both IMiDs and proteasome inhibitors may worsen peripheral neuropathy, potentially limiting the dose able to be given or as a class altogether depending on the severity of neuropathy. Diabetic nephropathy poses similar limitations.
