A Hospital-based Prospective Study of Hypomagnesemia in Type 2 Diabetes Mellitus Patients
Brij Mohan Gupta
Citation Information :
Gupta BM. A Hospital-based Prospective Study of Hypomagnesemia in Type 2 Diabetes Mellitus Patients. J Mahatma Gandhi Univ Med Sci Tech 2021; 6 (2):56-59.
Background: Magnesium is the second most abundant intracellular cation in the body and recently there has been an emerging interest in its major role played in various physiological and disease states of the body. Its deficiency is being correlated with pathogenesis, glycemic control, and various complications occurring in patients of diabetes mellitus (DM) in many studies.
Aim and objective: To estimate serum magnesium levels in diabetic patients and correlating it with pathogenesis, duration of diabetes, poor glycemic control, and various complications in our tertiary care hospital patients.
Materials and methods: This is a case-control, prospective study comprising 120 diabetic patients diagnosed as per recommended criteria of ADA and were evaluated at NIMS Medical College, Jaipur, Rajasthan. Keeping serum magnesium value threshold of 1.6 mg/dL, all patients were divided into two groups; hypomagnesemic(s) and normomagnesemic(s). Twenty-five healthy age-matched controls were also enrolled and compared.
Results: We observed 120 patients (52.5% males and 47.5% females), with age ranges between 36 years and 78 years; however, 60% of patients were in the range of 40–65 years. Mean serum values in hypomagnesemic, normomagnesemic, and healthy controls were detected in the range 1.54 ± 0.43, 1.81 ± 0.56, and 2.12 ± 0.67, respectively. 60.8% of diabetic patients had one or more diabetic complications; more in hypomagnesemic (83.3%) compared with normomagnesemic (51.9%). Microvascular complications were the most common. A single case of neuromuscular weakness was also detected.
Conclusion: Hypomagnesemia is common in patients of type 2 DM (T2DM) and has a negative correlation with its incidence, duration of disease, poor glycemic control, and various complications of DM. The therapeutic potential of serum magnesium is worth exploring via large clinical trials. Since replenishment of serum magnesium is a simple clinical entity, thus, it will be prudent to measure serum magnesium in each diabetic patient and replenish it accordingly.
Pham PC, Pham PM, Pham SV, et al. Hypomagnesaemia in patients with type 2 diabetes. Clin J Am Soc Nephrol 2007;2(2):366–372. DOI: 10.2215/CJN.02960906.
de Lordes Lima M, Cruz T, Pousada JC, et al. The effect of magnesium supplementation in increasing doses on the control of Type 2 DM. Diabetes Care 1998;21(5):682–686. DOI: 10.2337/diacare.21.5.682.
Wälti MK, Zimmermann MB, Walczyk T, et al. Measurement of magnesium absorption and retention in type 2 DM with use of stable isotopes. Am J Clin Nutr 2003;78(3):448–453. DOI: 10.1093/ajcn/78.3.448.
Correa ZM, Freitas AM, Marcon IM. Risk factors related to the severity of diabetic retinopathy. Arq Bras Oftalmil 2003;66(6):739–743. DOI: 10.1590/S0004-27492003000700002.
Harrison's principles of internal medicine. 18th ed., McGraw Hill; 2011. pp. 2968–3002.
Raheja BS, Kapur A, Bhoraskar A, et al. Diabetes care Asia – India study: Diabetes care in India current status. J Assoc Physicians India 2001;49:717–722.
Kulkarni AG, Shendge SK, Shinde V. Study of serum magnesium level in type 2 diabetes mellitus. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2014;13(4 Ver. VII):115–119. DOI: 10.9790/0853-1347115119.
Kauser MM, Afreen A, Prabhakar K, et al. Study of serum magnesium in type 2 diabetes mellitus and its correlation with the modality of treatment - A South Indian study. Int J Biomed Adv Res 2014;5(8):361–363. DOI: 10.7439/ijbarSSN: 2229-3809 (Online) Journal.
Ramadass S, Basu S, Srinivasan AR. SERUM magnesium levels as an indicator of status of diabetes mellitus type 2. Diabetes Metab Syndr 2015;9(1):42–45. DOI: 10.1016/j.dsx.2014.04.024.
Barbagallo M, Dominguez LJ. Magnesium metabolism in type 2 diabetes mellitus, metabolic syndrome and insulin resistance. Arch Biochem Biophys 2007;4558(1):40–47. DOI: 10.1016/j.abb.2006.05.007.
Takaya J, Higashino H, Kobayashi Y. Intracellular magnesium and insulin resistance. Magnes Res 2004;17(2):126–136.
Djurhuus MS. New data of mechanisms of hypomagnesemia in type 1 diabetes mellitus. Magnes Res 2001;14(3):217–223.
Rude RK. Magnesium deficiency and diabetes mellitus causes and effects. Postgrad Med J 1992;92(5):217–224. DOI: 10.1080/00325481.1992.11701494.
Rayssignier Y. Role of magnesium and potassium in the pathogenesis of arteriosclerosis. Magnesium 1984;3:226–238.
Ma J, Folsom AR, Melnick SL, et al. Association of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: The ARIC study. Atherosclerosis risk in communities study. J Clin Epidemio 1995;48(7):927–940. DOI: 10.1016/0895-4356(94)00200-A.
Guerrero-Romero F, Rodriguez-Moran M. Hypomagnesaemia, oxidative stress, inflammation, and metabolic syndrome. Diabetes Metab Res Rev 2006;22(6):471–476. DOI: 10.1002/dmrr.644.
Mohan V, Shanthirini CS, Deepa M. Chennai urban population study-16. Diabesis Res Clin pract 1998;34(1):29–36. DOI: 10.1016/S0168-8227(96)01327-7.
De Leeuw I, Engelen W, De Block C, et al. Long term magnesium supplementation influences favourably the natural evolution of neuropathy in Mg-depleted type 1 diabetic patients (T1dm). Magnes Res 2004;17(2):109–114.
Corsonello A, Ientile R, Buemi M, et al. Serum ionized magnesium levels in type 2 diabetic patients with microalbuminuria or clinical proteinuria. Am J Nephrol 2000(3):187–192. DOI: 10.1159/000013582.
Fujii S, Takemura T, Wada M, et al. Magnesium levels in plasma erythrocytes and urine in patients with diabetes mellitus. Horm Metab Res 1982;14(3):61–62. DOI: 10.1055/s-2007-1018954.
Dasgupta A, Saikia UK, Sharma D, et al. Quadriparesis in diabetes due to dyselectrolytemia. Indian J Endocrinol Metal 2010;14(1):27–29.
Huang CL, Kuo E. Mechanism of hypokalemia in magnesium deficiency. J Am Soc Nephrol 2007;18(10):2649–2652. DOI: 10.1681/ASN.2007070792.
Suh S, Tashjian A, Matsuo N, et al. Pathogenesis of hypocalcemia in primary hypomagnesaemia: normal end-organ responsiveness to parathyroid hormone, impaired parathyroid gland function. J Clin Invest 1973;52(1):153–160. DOI: 10.1172/JCI107159.
Paolisso G, Sgambato S, Pizza G, et al. Improved insulin response and action by chronic magnesium administration in aged NIIDM subjects. Diabetes Care 1989;12(4):265–269. DOI: 10.2337/diacare.12. 4.265.
Volpe SL. Magnesium in disease prevention and overall health. Adv Nutr 2013;4(3):378S–383SS. DOI: 10.3945/an.112.003483.