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We conducted a retrospective cohort study of US Veterans diagnosed with MGUS from 10\/1\/1999-12\/31\/2023 with prior DM. MGUS and MM diagnoses were confirmed using published natural language processing-assisted models. The exposure was time-varying glycated hemoglobin (HbA1c)\u2009&gt;\u20097% during the follow-up (time of MGUS to MM, death, or being censored on 4\/15\/2025, whichever occurred first). The outcome was time from MGUS to MM. The association was estimated by multivariable-adjusted hazard ratio (aHR) using a Fine-Gray subdistribution hazard model with death as a competing event, adjusted by inverse probability of treatment weighting (IPTW). Among 11,061 patients with DM, HbA1c\u2009&gt;\u20097% was associated with increased progression risk (aHR 1.15; 95% confidence interval [CI] 1.01\u20131.32). This association was stronger in the subgroups of Type-2 DM (T2DM) with insulin use (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20097070; aHR 1.46; 95% CI 1.19\u20131.78) and non-use (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20093724; aHR 1.42; 95% CI 1.14\u20131.77) throughout follow-up. For patients with T2DM and MGUS, poorly controlled diabetes may be associated with progression risk to MM. Future studies are needed to confirm this relationship.\n                  <\/jats:p>","DOI":"10.1038\/s41408-026-01592-x","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:16:47Z","timestamp":1785752207000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between diabetic control and progression of monoclonal gammopathy of undetermined significance to multiple myeloma"],"prefix":"10.1038","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8559-7739","authenticated-orcid":false,"given":"Lawrence","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron","family":"Sigel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Grandhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6388-5553","authenticated-orcid":false,"given":"Martin W.","family":"Schoen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen M.","family":"Sanfilippo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth R.","family":"Carson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murali","family":"Janakiram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2053-3942","authenticated-orcid":false,"given":"Tzeyu L.","family":"Michaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7307-0291","authenticated-orcid":false,"given":"Graham A.","family":"Colditz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore S.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5872-9556","authenticated-orcid":false,"given":"Su-Hsin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"1592_CR1","unstructured":"SEER. 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Received travel support for annual conference from ASCO, ASH, and DAVA Oncology. Stocks in Pfizer and Roche. BS: none. NG: none. MW: none. TT: None. MS: Receives grant funding from the Astellas, Prostate Cancer Foundation, and Department of Defense paid to the institution, unrelated to this work. KS: Receives grant funding from the American Society of Hematology and National Heart, Lung and Blood Institute paid to the institution, not related to this work. Received payment for expert case review from Quinn & Johnston, not related to this work. MJ: honoraria from AbbVie, AstraZeneca, Kite\/Gilead, Janssen, Pierre Fabre, Sobi and Roche. S-HC: none.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"135"}}