Hypomagnesaemia in Type 2 (non-insulin-dependent) diabetes mellitus is not corrected by improvement of long-term metabolic control

Abstract

Low levels of magnesium have frequently been reported in diabetes mellitus especially in poorly controlled Type 1 (insulin-dependent) diabetic patients. Furthermore hypomagnesaemia might contribute to insulin resistance in Type 2 (non-insulin-dependent) diabetes. As the influence of improved metabolic control on plasma magnesium levels is unknown in Type 2 diabetic patients we studied magnesium plasma levels in 50 patients 1) before, 2) one and 3) three months after the initiation of insulin therapy or intensified treatment with oral hypoglycaemic agents. Magnesium plasma levels were measured by a colorimetric method and were significantly reduced in diabetic patients compared to healthy control subjects (0.79 +/- 0.01 mmol/l vs 0.88 +/- 0.01 mmol/l; p less than 0.0001). Metabolic control was significantly improved as documented by reduced HbA1C levels in both insulin-treated patients or the patients on oral hypoglycaemic agents (p less than 0.003). However, plasma magnesium levels remained unchanged during the follow-up in the insulin-treated group (1: 0.79 +/- 0.02 mmol/l; 2: 0.81 +/- 0.02 mmol/l; 3: 0.79 +/- 0.01 mmol/l) as well as in the patients on oral hypoglycaemic agents (1: 0.79 +/- 0.03 mmol/l; 2: 0.78 +/- 0.02 mmol/l; 3: 0.84 +/- 0.04 mmol/l). This study shows that even marked improvement of glycaemic control does not correct hypomagnesaemia in Type 2 diabetes. We conclude that hypomagnesaemia might be related to the insulin-resistant state and that possible beneficial effect of chronic magnesium administration should be evaluated in these patients.

Change in Glucose Homeostasis in Rats by Long-Term Magnesium-Deficient Diet.

“…The plasma Mg level was markedly lower in Mg-deficient rats throughout the experiment period. In Mg-deficient rats, Hypomagnesemia has been reported in both insulin-dependent (IDDM) and non-insulin-dependent diabetic (NIDDM) patients (1)(2)(3)(4)(5)(6). When compared with healthy subjects, diabetic patients have a decreased serum (or plasma) Mg level (1 6) and a decreased Mg content in erythrocyte (6) and muscular tissues (4), accompanied by increased urinary excretion of Mg (2,3).…”

Effect of magnesium supplementation on plasma glucose in patients with diabetes mellitus

“…In diabetes mellitus, magnesium depletion is a common occurrence (Speich et al, 1992;Schnack et al, 1992;Resnick et al, 1993), and it has been reported to exacerbate/contribute to reduced insulin sensitivity (Durlach and Rassiguier, 1983;Legrand et al, 1987) in non-insulin dependent diabetes mellitus. Magnesium administration was shown to increase plasma and erythrocyte magnesium levels and improve insulin response and action (Sjogren et al, 1988;Paolisso et al, 1992), due to an increased affinity of insulin to its receptors (Ishii, 1989).…”

Copper, Zinc and Magnesium in Non-Insulin-Dependent Diabetes Mellitus Treated with Metformin

“…Our data are in agreement with other authors who evinced that plasma levels of Mg have not improved at the same time with metabolic control improvement. [35] Within experimental research, the metformin restored endothelial function and significantly improved NO bioavailability in normal and high-fat fed rats. This supports the concept of metformin as a first-line therapeutic drug to treat diabetic patients in order to protect against endothelial dysfunction associated with type 2 diabetes mellitus.…”