Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2

Pham, Phuong Chi T.; Pham, Phuong Mai T.; Pham, Phuong Anh; Pham, Son V.; Pham, Hien; Miller, Jeffrey M.; Yanagawa, Norimoto; Pham, Phuong Thu

doi:10.5414/cnp63429

Cited by 114 publications

(93 citation statements)

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“…In a comparative study that involved 30 patients who had type 2 diabetes without microalbuminuria, 30 with microalbuminuria, and 30 with overt proteinuria, Corsonello et al (49) observed a significant decrease in serum ionized Mg in both the microalbuminuria and overt proteinuria groups compared with the nonmicroalbuminuric group. Accordingly, in a recent retrospective study, an association between low serum Mg levels and a significantly faster rate of renal function deterioration in patients with type 2 diabetes was reported (7).…”

Section: Hypomagnesemia In the Clinical Settingmentioning

confidence: 99%

“…Clinically, hypomagnesemia may be defined as a serum Mg concentration Յ1.6 mg/dl or Ͼ2 SD below the mean of the general population (7,8). However, because Mg is mostly an intracellular cation, it has been questioned whether one can use measurements of serum Mg concentrations to study the impact of Mg on various physiologic conditions.…”

Section: Diagnosis Of Hypomagnesemiamentioning

confidence: 99%

“…The wide range in the reported incidence of hypomagnesemia most likely reflects the difference in the definition of hypomagnesemia, techniques in Mg measurements, and the heterogeneity of the selected patient cohort. In terms of gender difference, it is interesting to note that independent studies have reported a higher incidence of hypomagnesemia in women compared with men, at a 2-to-1 ratio (7,14). In addition, men with diabetes may have higher ionized levels of Mg (15).…”

Section: Diagnosis Of Hypomagnesemiamentioning

confidence: 99%

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Hypomagnesemia in Patients with Type 2 Diabetes

Pham

Pham³

et al. 2007

Clinical Journal of the American Society of Nephrology

357

339

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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.

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Section: Hypomagnesemia In the Clinical Settingmentioning

confidence: 99%

Section: Diagnosis Of Hypomagnesemiamentioning

confidence: 99%

Section: Diagnosis Of Hypomagnesemiamentioning

confidence: 99%

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Hypomagnesemia in Patients with Type 2 Diabetes

Pham

Pham³

et al. 2007

Clinical Journal of the American Society of Nephrology

357

339

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“…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 .…”

Section: Discussionmentioning

confidence: 99%

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

Kauser¹,

Afreen

Prabhakar

et al. 2014

Int J of Biomed & Adv Res

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“…Hypomagnesemia is reported as a predictor of ESRD in patients with type 2 diabetic nephropathy [21,22]. Lower dietary magnesium intake was independently associated with greater odds of rapid kidney function decline [23].…”

Section: Mg Concentration Increases With Sglt2 Inhibitor Treatmentmentioning

confidence: 99%

Is the Renoprotective Effect of SGLT2 Inhibitors due to their Beneficial Effect on Hypomagnesemia?

Yanagawa¹

2017

J Diabetes Metab

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Magnesium (Mg) deficiency is linked to diabetes and cardiovascular (CV) events. Treatment with the sodiumglucose cotransporter 2 (SGLT2) inhibitor was associated with a suppressed occurrence of CV events in patients with type 2 diabetes. We recently suggested that the increase of the serum Mg level associated with SGLT2 inhibitor treatment could explain, at least in part, the reduction of the CV events. Recently SGLT2 inhibitors have also been reported to exert a renoprotective effect and various hypotheses have been proposed regarding the mechanism. Now we would like to propose another possible mechanism, namely, the role of Mg.Keywords: Magnesium; Sodium-glucose cotransporter 2 inhibitor; Diabetic nephropathy; Renoprotection Magnesium Deficiency is linked to Diabetes, Hypertension and Cardiovascular EventsMagnesium (Mg) acts as a coenzyme in the insulin secretion pathway, influences the insulin sensitivity, and acts as a modulator of Na-K ATPase. Insufficient intake of Mg can cause diabetes [1] and hypertension.Mg exerts favorable effects on the cardiovascular (CV) system, including an anti-inflammatory effect on the vascular endothelium and smooth muscle, vascular relaxant activity, and sympatholytic activity [2]. Of the total Mg content of the body, 99% is present within the cells, and only 1% is present outside cells. Thus, while hypomagnesemia reflects Mg deficiency in the whole body, Mg deficiency could be present even in the presence of serum Mg levels within the normal range [3]. Subjects with hypomagnesemia are known to be at an elevated risk of developing CV disease [4]. According to the findings of the Framingham Heart Study, hypomagnesemia is a risk factor for atrial fibrillation [5]; hypomagnesemia has also been reported to be associated with a risk of premature ventricular contractions, particularly in diabetic patients [6]. In addition, animal experiments have shown that hypomagnesemia causes reduced cardiac function [7]. Furthermore, hypomagnesemia has been reported to increase platelet aggregation, thereby facilitating thrombus formation, and to enhance coronary artery constriction, thereby increasing the risk of development of myocardial infarction [2].A high incidence of CV events and sudden death has also been reported in patients with hypomagnesemia. A meta-analysis of relevant studies, even those including patients without diabetes, revealed that elevation of the serum Mg level by 0.2 mmol/L was associated with a 30% decrease in the risk of onset of CV disease and 40% decrease in the risk of death from CV events [8]. Adequate dietary magnesium intake has been reported to be associated with a reduced risk of cardiovascular events [9]. Thus, it might be reasonable to conclude that the risk of CV disease/events decreases as the serum Mg concentration increases. Mg Concentration Increases with SGLT2 Inhibitor TreatmentSodium-glucose cotransporter 2 (SGLT-2) is expressed in the proximal renal tubules, where it reabsorbs about 80-90% of the filtered glucose. Selective and reversible inhi...

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Lower serum magnesium levels are associated with more rapid decline of renal function in patients with diabetes mellitus type 2

Cited by 114 publications

References 0 publications

Hypomagnesemia in Patients with Type 2 Diabetes

Hypomagnesemia in Patients with Type 2 Diabetes

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

Is the Renoprotective Effect of SGLT2 Inhibitors due to their Beneficial Effect on Hypomagnesemia?

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