Study of serum magnesium level in patients with type 2 diabetes mellitus and it’s correlation with glycosylated hemoglobin and diabetic complications

Abdul Wahid, Girish C. Verma, C. P. Meena, A. R. Pathan


Background: Hypomagnesemia has been proposed as a novel factor implicated in the pathogenesis of poor glycemic control and diabetic complications. Aim of the present study is to study serum magnesium level in patients with type 2 DM and to find the correlation between serum magnesium levels, HbA1c and diabetic complications.

Methods: 100 patients with Type 2 DM (50 males and 50 females) who were diagnosed on the basis of ADA criteria or taking treatment for Diabetes were included in the study. All patients underwent tests for serum magnesium level, fasting blood sugar, postprandial blood sugar, HbA1c and also target organ evaluation for Diabetes. A detailed history and examination was also done.

Results: There was significant difference in the prevalence of hypomagnesemia (34% vs 6%) and serum magnesium levels (1.59±0.187 versus 1.78±0.126, p <0.0001) between diabetics and control group. FBS (172.17±30.55 versus 137.06±37.76, p<0.0001), PPBS (243±61.21 versus 195.84±59.1, p = 0.0003) and HbA1C (8.42±1.292 versus 7.04±0.956, p<0.0001) were significantly higher in hypomagnesemic diabetics as compared to normomagnesemic diabetics. Significant proportion of hypomagnesemic diabetics were suffering from retinopathy as compared to normomagnesemic diabetics (47.06% versus 19.70%, p = 0.0042). Diabetic nephropathy, neuropathy, hypertension and IHD were also higher in hypomagnesemic diabetics as compared to normomagnesemic diabetics, but insignificant.

Conclusions: Prevalence of hypomagnesemia in Type 2 diabetics was 34%. Diabetics with hypomagnesemia had poor glycemic control. Hypomagnesemia was significantly associated with diabetic retinopathy.



Diabetic retinopathy, Glycosylated haemoglobin, Hypomagnesemia, Type 2 DM

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Harrison’s Principles of Internal Medicine; 18th Edition. McGraw Hill; 2011:2968-3002.

Garfinkel D. Role of magnesium in carbohydrate oxidation. Magnesium. 1988;7:249-61.

Grafton G, Baxter MA, Sheppard MC. Effects of magnesium on sodium dependent inositol transport. Diabetes. 1992;41:35-9.

Nadler JC, Rude RK. Disorders of magnesium metabolism. Endocrinol Metab Clinic North Am. 1995;24:623-41.

Ma J, Folsom AR, Melnick SL, Eckfeldt JH, Sharret AR, Nabulsi AA, et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin and carotid arterial wall thickness. The atherosclerosis risk in communities (ARIC) study. J Clin Epidemiol. 1995;48:927-40.

Rude RK. Magnesium deficiency and diabetes mellitus - causes and effects. Postgrad Med J. 1992;92:217-24.

Nadler JL, Buchnan T, Natarajan R, Antonipillai I, Bergman R, Rude RK. Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertension. 1993;21:1024-9.

Schlinger JL, Grunenberger F, Maier EA, Simon C, Chabrier G, Leroy MJF. Disturbances of plasma trace elements in diabetes - relations with glycemic control. Presse Med. 1988;17:10769.

McNair P, Christiansen C, Madsbad S, Lauritzen E, Faber O, Binder C, et al. Hypomagnesemia - a risk factor in diabetic retinopathy. Diabetes. 1978;27:1075-7.

Mather HM, Levin GE, Nisbet JA. Hypomagnesemia and ischemic heart disease in diabetes. Diabetes Care. 1982;5:452-3

Andrea C, Ricardo L, Michele B, Domenico C, Vittorio NM, Salvatore M, et al. Serum ionized magnesium levels in type-2 diabetic patients with microalbuminuria or clinical proteinuria. Am J Nephrol. 2000;20:187-92.

Kao WH, Folsom AR, Nieto FJ, Mo JP, Watson RL, Brancati FL. Serum and dietary magnesium and the risk for type 2 diabetes mellitus: The Atherosclerosis Risk in Communities Study. Arch Intern Med. 1999;159:2151-9 .

De Lordes Lima M, Cruz T, Pousada JC, Rodrigues LE, Barbosa K, Cangucu V. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care. 1998;21:682-6.

Garland HO. New experimental data on the relationship between diabetes mellitus and magnesium. Magnes-Res. 1992;5:193-202.

De Valk HW, Verkaaik R, Van Rijn HJM. Oral magnesium supplementation in insulin requiring type 2 diabetes mellitus. Diabet Med. 1998;15:503-7.

Sack DB, Bruns De, Goldstein DE, Maclaren NK, Mcdonald JM, Parott M. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chemis. 2002;48(3):436-72.

McNair P, Christiansen MS, Christiansen C, Madsbad S, Transbiol I. Renal hypomagnesemia in human diabetes mellitus: its relation to glucose homeostasis. European J Clin Invest. 1982;12:81-5.

Song Y, Buring JE, Manson JE, Liu S. Dietary magnesium intake in relation to plasma insulin levels and risk of type 2 diabetes in women. Diabetes Care. 2004;27(1):59-65.

Walti MK, Zimmermann MB, Hurrell RF. Low plasma magnesium in type 2 diabetes. Swiss Med Wkly. 2003;133:289-92.

Hamdan TK, Abbas MR, Ghassan AA. Hypomagnesemia and obesity in relation to insulin resistance and glycemic control in type 2 diabetic patients. Iraqi J Med Sci. 2011;9(2).

Lal J, Vasudev K, Kela AK, Jain SK. Effect of oral magnesium supplementation on lipid profile and blood glucose of patients with type 2 diabetes mellitus. JAPI. 2003;51:37-42.

Sales CH, Campos Pedrosa LF, Lima JG. Influence of magnesium status and magnesium intake on the blood glucose control in patients with type 2 diabetes. Clin Nutr. 2011;30(3):359-64.

Yajnik CS, Smith RF, Hockaday TD, Ward NI. Fasting plasma magnesium concentrations and glucose disposal in diabetes. BMJ. 1984;288:1032-4.

Alzaida A, Dinnean SF, Moyer TP, Rizza RA. Effects of insulin on plasma magnesium in non-insulin dependent diabetes mellitus: evidence of insulin resistance. J Clin Endocrinol Metab. 1995;80:1376-81.

Corica F, Corsonello A, Ientile R, Cucinotta D. Serum ionized magnesium levels in relation to metabolic syndrome in type 2 diabetic patients. J Am Col Nutr. 2006;25(3):210-5.

Serum ionized magnesium levels in type 2 diabetic patients with microalbuminuria or clinical proteinuria. Am J Nephrol. 2000;20(3):187-92.

Nagase N. Hypertension and serum magnesium in the patients with diabetes and coronary heart disease. Hypertens Res. 1996;19:65-8.

Tosiello L. Hypomagnesemia and diabetes mellitus. A review of clinical implications. Arch Intern Med. 1996;156:1143-8.

Dzurik R, Stetikova K, Spustova V. The role of magnesium deficiency in insulin resistance- an invitro study. J Hypertens. 1991;9(6):S312-3.

Liao F, Folsom AR, Brancati FL. Is low magnesium concentration a risk factor for coronary heart disease? The ARIC study. Am Heart J. 1998;136:480-90.

Hatwal A, Gujral AS, Bhatia RP, Agarwal JK, Bajpai HS. Association of hypomagnesemia with diabetic retinopathy. Acta Ophtalmol. 1989;67:714-6.

Pham PC, Pham PM, Pham PA, Miller JM, Yanagawa N. Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2. Clin Nephrol. 2005;63(6):429-36.