Hypomagnesemia in Patients with Type 2 Diabetes

Abstract

Hypomagnesemia has been reported to occur at an increased frequency among patients with type 2 diabetes compared with their counterparts without diabetes. Despite numerous reports linking hypomagnesemia to chronic diabetic complications, attention to this issue is poor among clinicians. This article reviews the literature on the metabolism of magnesium, incidence of hypomagnesemia in patients with type 2 diabetes, implicated contributing factors, and associated complications. Hypomagnesemia occurs at an incidence of 13.5 to 47.7% among patients with type 2 diabetes. Poor dietary intake, autonomic dysfunction, altered insulin metabolism, glomerular hyperfiltration, osmotic diuresis, recurrent metabolic acidosis, hypophosphatemia, and hypokalemia may be contributory. Hypomagnesemia has been linked to poor glycemic control, coronary artery diseases, hypertension, diabetic retinopathy, nephropathy, neuropathy, and foot ulcerations. The increased incidence of hypomagnesemia among patients with type 2 diabetes presumably is multifactorial. Because current data suggest adverse outcomes in association with hypomagnesemia, it is prudent to monitor magnesium routinely in this patient population and treat the condition whenever possible.

Association of Insulin Resistance, β-Cell Function Impairment and Calcium, Magnesium, and Fetuin-A Concentrations in Women with Type 2 Diabetes Mellitus

“…Low serum Mg is a strong independent predisposing factor of IR and T2DM development (39). Therefore, reduced serum Mg level in T2DM may be associated with an increased urinary loss of Mg (9). These results are also consistent with those described in other studies.…”

“…IR in DM can enhance Mg excretion through the kidney. Thus, reduced serum Mg level in T2DM may promote the urinary loss of Mg (9). These results indicated that the reduction of the serum levels of some essential trace metals may be associated with the occurrence of T2DM.…”

“…Mg activates all enzymatic reactions that require ATP or kinase (9). Mg also participates in carbohydrate metabolism.…”

Study of serum magnesium in type 2 Diabetes Mellitus and its correlation with the modality of treatment- A south Indian study

“…Inverse correlations between magnesium and fasting plasma glucose, HbA1C, HOMA-IR have been observed. 11,12 Factors implicated in hypomagnesemia in diabetics include diets low in magnesium 13 ,osmotic diuresis causing high renal excretion of magnesium, insensitivity to insulin affecting intracellular magnesium transport and thereby causing increased loss of the extracellular magnesium 14 rampant use of loop and thiazides diuretics promoting magnesium wasting, 15,16 diabetic autonomic neuropathies 4 and reduced tubular reabsorption due to insulin resistance 17 . Sometimes the more common use of antibiotics and antifungals such as aminoglycosides and amphotericin in patients with diabetes may also contribute to renal magnesium wasting 18 .…”

“…Magnesium is the fourth most abundant cation in the human body and the second most abundant intracellular cation 4 . It plays an important role in the carbohydrate metabolism.…”