What are some preferred steroid sparing regimens for untreated multiple myeloma patients who have type 1 diabetes mellitus?

The amount of dexamethasone used in current regimens is less than historical regimens of 40 mg daily x 4 days, etc. based on an ECOG trial comparing 40 mg weekly to the older standard (both in combination with Revlimid) https://www.ncbi.nlm.nih.gov/pubmed/19853510. Nevertheless, the amount is still significant enough to affect glucose management.

For your patient, I would probably use the current schedule of your regimen and then have a low threshold to adjust the dexamethasone downward, dependi...