Association of Low Magnesium Level With Duration and Severity of Type 2 Diabetes

Abstract

Introduction: Type 2 diabetes mellitus can give rise to several complications in the body, including electrolyte imbalance. In this study, we aim to find the association of hypomagnesemia with the duration and severity of diabetes. Understanding the association between magnesium and diabetes may assist in the early detection of hypomagnesemia and help manage the complications associated with electrolyte imbalance. Methods: This cross-sectional study was conducted in the internal medicine department of a tertiary care hospital in Pakistan from January to March 2021. Three hundred (n = 300) patients with a confirmed diagnosis of type 2 diabetes were enrolled in the study after informed consent via consecutive convenient non-probability sampling. Three hundred (n = 300) patients were included in the study as a reference group. Blood was drawn via phlebotomy and sent to the laboratory to assess glycated hemoglobin (HbA1c) and magnesium levels. Results: In uncontrolled diabetic patients, mean magnesium level was significantly lower as compared to diabetic patients with good glycemic control (1.34 ± 0.3 mg/dL vs. 1.81 ± 0.5; p-value: <0.0001). Prevalence of hypomagnesemia was significantly more in patients with uncontrolled diabetes, compared to the controlled diabetic group (65.8% vs. 50.8%; p-value: 0.009). In patients with a duration of diabetes of more than 10 years, the mean magnesium level was significantly lower, compared to patients with less than 10 years of diabetes (1.32 ± 0.3 mg/dL vs. 1.78 ± 0.5; p-value: <0.0001). Prevalence of hypomagnesemia was significantly more in patients with diabetes for more than 10 years (64.7% vs. 51.9%; p-value: 0.02). Conclusion: Hypomagnesemia is prevalent in diabetes and is directly related to the severity and duration of diabetes. It is important to include electrolyte screening as a part of routine screening in diabetic patients for early detection and management of electrolyte imbalance, including hypomagnesemia.

Why Magnesium Level Check Should be Part of Standard Diabetes Care?

“…Increasing data reveal that the prevalence of hypomagnesemia is high in patients with diabetes, although it varies according to study design and population characteristics, and hypomagnesemia is mostly associated with advanced age, diabetes duration, diabetes severity, treatment characteristics, and diabetic micro-and macrovascular complications. [8][9][10] For example, in an observational cohort study including 929 patients with type 2 diabetes treated in primary care, the frequency of hypomagnesemia was found to be 9.6%, and it was shown that age, duration of diabetes, body mass index, HbA1c, metformin, sulfonylurea, and DPP-4 inhibitor use were negatively associated with magnesium concentration. 4 Similar to our study, in an observational study conducted on outpatients with type 2 diabetes, the frequency of hypomagnesemia was found to be 12.9%, and it was stated that hypomagnesemia was associated with poor glycemic control and contributed to the development and progression of micro-and Second; The reason is that the cases using proton pump inhibitors were found to be significantly higher both in the group with diabetes than in the nondiabetic group and in individuals with diabetes and hypomagnesemia compared to those with normal magnesium.…”

Assessment of Electrolyte Imbalance and Associated Factors Among Adult Diabetic Patients Attending the University of Gondar Comprehensive Specialized Hospital, Ethiopia: A Comparative Cross-Sectional Study

“… 31 While our finding was lower than Pakistan (57.3%), Nepal (50%), and India (44%). 9 , 32 , 33 Variation in the targeted groups may be related to dietary habits, the severity of DM, and the heterogeneity of the selected patient.…”

“…Our findings were comparable with a study done in Pakistan and India. 32 , 47 Due to insulin’s role in regulating Mg 2+ reabsorption in the kidney through the TRPM 6 channel. Insulin resistance or insulin deficit decreased renal magnesium absorption by blocking the TRPM 6 channel, which led to urine magnesium wasting.…”

Mối liên quan giữa hạ Ma - giê máu và biến chứng võng mạc trên người đái tháo đường típ 2

“…Pratyush Kumar (Ấn Độ) báo cáo tỉ lệ này đến 44 % có lẽ do khác biệt cỡ mẫu và một số đặc điểm như HbA1C và BMI đều cao hơn. Trên 300 BNĐTĐ típ 2 Ruchir Paladiya ghi nhận nồng độ Mg máu trung bình khá thấp (0,66mmol/L) và tỉ lệ hạ Mg 57,3% nhiều gấp hai lần kết quả của chúng tôi [7] do tiêu chuẩn chọn bệnh của họ ít chặt chẽ, không loại người có uống thuốc hoặc có bệnh lý làm hạ Mg máu.…”