Hypomagnesemia in Type 2 Diabetic Nephropathy

Sakaguchi, Yusuke; Tanaka, Shōji; Hayashi, Terumasa; Suzuki, Akira; Shimizu, Morihiro; Mitsumoto, Kensuke; Kawabata, Hiroaki; Niihata, Kakuya; Okada, Noriyuki; Isaka, Yoshitaka; Rakugi, Hiromi; Tsubakihara, Yoshiharu

doi:10.2337/dc12-0226

Cited by 109 publications

(96 citation statements)

References 33 publications

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“…Hypomagnesaemia has also been linked to diabetic nephropathy (from microalbuminuria to advanced renal disease) [3]. It has been proposed that hypomagnesaemia is a predictor of end-stage renal disease in patients with diabetic nephropathy [3]. In addition, magnesium deficit is associated with carbohydrate intolerance and insulin resistance, thus inducing or worsening existing DM [4].…”

Section: Introductionmentioning

confidence: 99%

“…Hypomagnesaemia has been implicated in various long-term complications of DM, such as hypertension, increased carotid wall thickness, coronary artery disease, dyslipidemia, diabetic retinopathy, neuropathy, ischemic stroke, and foot ulcerations [2]. Hypomagnesaemia has also been linked to diabetic nephropathy (from microalbuminuria to advanced renal disease) [3]. It has been proposed that hypomagnesaemia is a predictor of end-stage renal disease in patients with diabetic nephropathy [3].…”

Section: Introductionmentioning

confidence: 99%

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The Relationship between Hypomagnesaemia and Glycemic Control in Children with Type 1 Diabetes Mellitus

Asmaa¹,

Samira²

2016

J Diabetes Metab

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Background: Hypomagnesaemia is common in adult patients with both Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes MellitusT2DM, especially in poorlycontrolled and chronically treated adults. However, to our knowledge, little research has addressed the relationship between serum magnesium levels and diabetes in children. The aim of the present study was to evaluate magnesium levels and examine their possible association with glycemic control in children with T1DM.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Relationship between Hypomagnesaemia and Glycemic Control in Children with Type 1 Diabetes Mellitus

Asmaa¹,

Samira²

2016

J Diabetes Metab

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“…In type 2 diabetic subjects, even in the absence of elevated blood pressure, suppressed intracellular Mg levels are associated with cardiac hypertrophy, and specifically with increased echocardiographically measured posterior wall thickness and left ventricular mass index in both diabetic and/or hypertensive subjects [29]. Similarly, aortic distensibility values determined by magnetic resonance imaging in normal and hypertensive humans were closely and positively related to concomitantly measured levels of cellular Mg measured in situ in brain and skeletal muscle tissue by 31 P-NMR magnetic resonance spectroscopic techniques: the more suppressed the intracellular Mg, the stiffer (less distensible) the aorta [30]. Low serum Mg concentrations are associated with a high prevalence of premature ventricular complexes in obese adults with type 2 diabetes [6].…”

Section: Mg Deficiency and Cardio-metabolic Diseasesmentioning

confidence: 91%

“…In patients with type 2 diabetes mellitus, low circulating Mg levels have been associated also with a more rapid decline of renal function. Hypomagnesaemia is currently considered an accurate predictor of progression to end stage renal disease and death and in patients with type 2 diabetic nephropathy [31][32][33]. A Mg deficit have been associated to cognitive decline [34], multimorbidity [35] and aging [28,36].…”

Section: Mg Deficiency and Cardio-metabolic Diseasesmentioning

confidence: 99%

Magnesium and Type 2 Diabetes: An Update

Barbagallo¹

2015

Int J Diabetes Clin Res

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The link between magnesium (Mg) deficiency and type 2 diabetes mellitus is well known. Type 2 diabetes is frequently associated with both extracellular and intracellular Mg deficits. A chronic latent Mg deficit or an overt clinical hypomagnesaemia is common in subjects with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss appear the most important mechanisms that may favor Mg depletion in patients with type 2 diabetes. Low dietary Mg intake has been related to the development of type 2 diabetes and metabolic syndrome. Benefits of Mg supplementation on metabolic profile in diabetic subjects have been found in most, but not all clinical studies and larger prospective studies are needed to support the potential role of dietary Mg supplementation as a possible public health strategy in diabetes risk.The objective of this review is to revise current evidences on the mechanisms of Mg deficiency in diabetes mellitus type 2 and on the possible role of Mg supplementation in the prevention and management of the disease.

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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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Hypomagnesemia in Type 2 Diabetic Nephropathy

Cited by 109 publications

References 33 publications

The Relationship between Hypomagnesaemia and Glycemic Control in Children with Type 1 Diabetes Mellitus

The Relationship between Hypomagnesaemia and Glycemic Control in Children with Type 1 Diabetes Mellitus

Magnesium and Type 2 Diabetes: An Update

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

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