Title: Correlation of Serum Magnesium Levels with Microvascular Complications among Type 2 Diabetes patients in South India
Authors: Dr Sarah S Premraj MD, Dr A.S. Bharranitharan, Dr Rajasekaran D MD, Dr Udayashankar D MD
DOI: https://dx.doi.org/10.18535/jmscr/v6i2.62
Abstract
Background: Hypomagnesemia has been found to be associated with unfavorable effects on glucose homeostasis and insulin sensitivity in Type 2 Diabetes Mellitus (DM). If a relationship between levels of serum magnesium and microvascular complications can be established, it may form the basis for firther research on supplementation of magnesium in these patients.
Aims: To assess the level of serum magnesium levels in Type 2 DM patients and to correlate serum magnesium concentration with microvascular complications in these patients.
Methods: Cross sectional study in adult patients with type 2 diabetes presenting to a tertiary care center in semi-urban South India. Patients were subjected to history taking and detailed physical examination, including assessment of peripheral neuropathy by Toronto Clinical Neuropathy score. Basic investigations including HbA1c, Urine spot protein-creatinine ratio, as well as fundus examination for assessment of diabetic retinopathy were performed. Serum Magnesium level was analyzed in all patients, and its correlation with microvascular complications was computed by appropriate statistical methods.
Results: A total of 105 patients meeting the inclusion criteria were recruited. Mean age of the study population was 56.92 ±11.14 years with mean duration of 8.18 ±4.88 years of diabetes, and mean HbA1c level of 11.014±2.12%. The serum magnesium level of the study population was 1.96±0.177 mg/dl (Mean±SD). Hypomagnesemia was found in 8.6% of the study population with diabetic retinopathy, 5.2% with diabetic neuropathy and 14.3% with diabetic nephropathy. The study established a statistically significant correlation between low serum magnesium levels and all the three microvascular complications (p value< 0.001).
Conclusion: Hypomagnesemia is associated with microvascular complications in patients with Type 2 diabetes. Since microvascular complications are the leading cause of morbidity in type 2 diabetes, screening for hypomagnesmia may be indicated in these patients with longer duration of diabetes.
References
- Cernea S, Dobreanu M. Diabetes and beta cell function: from mechanisms to evaluation and clinical implications. Biochem Medica. 2013 Oct 15;23(3):266–80.
- Siddiqui K, Bawazeer N, Scaria Joy S. Variation in Macro and Trace Elements in Progression of Type 2 Diabetes. Sci World J. 2014 Aug 5;2014:e461591.
- Barbagallo M, Dominguez LJ. Magnesium and type 2 diabetes. World J Diabetes. 2015 Aug 25;6(10):1152–7.
- Haque WMM, Khan AR, Nazimuddin K, Musa AKM, Ahmed AS, Sarker RSC. Frequency of Hypomagnesemia in Hospitalized Diabetic Hypokalemic Patients. J Bangladesh Coll Physicians Surg. 2008;26 (1):10–3.
- Arpaci D, Tocoglu AG, Ergenc H, Korkmaz S, Ucar A, Tamer A. Associations of serum Magnesium levels with diabetes mellitus and diabetic complications. Hippokratia. 2015;19 (2):153–7.
- Lu J, Gu Y, Guo M, Chen P, Wang H, Yu X. Serum Magnesium Concentration Is Inversely Associated with Albuminuria and Retinopathy among Patients with Diabetes. J Diabetes Res. 2016 Jul 31;2016:e1260141.
- Fujii S, Takemura T, Wada M, Akai T, Okuda K. Magnesium levels of plasma, erythrocyte and urine in patients with diabetes mellitus. Horm Metab Res Horm Stoffwechselforschung Horm Métabolisme. 1982 Mar;14(3):161–2.
- Corsonello A, Ientile R, Buemi M, Cucinotta D, Mauro VN, Macaione S, et al. Serum ionized magnesium levels in type 2 diabetic patients with microalbuminuria or clinical proteinuria. Am J Nephrol. 2000 Jun;20(3): 187–92.