Monitoring Serum Magnesium Levels Helps Manage Hypomagnesemia for Patients With Type 2 Diabetes

Monitoring serum magnesium levels can help to manage hypomagnesemia, decrease complications, and increase overall care for patients with type 2 diabetes (T2D), according to investigators who published their findings in The Journal of the International Federation of Clinical Chemistry and Laboratory Medicine.¹ Further, physicians, nurses, and pharmacists working together is essential to resolve magnesium deficient. In particular, pharmacists play a critical role in assessing whether medications are causing deficiency or providing guidance on the selection of the most applicable supplement.⁴

Magnesium, Diabetes, Supplements, Hypomagnesemia | Image Credit: ©сергей назаров | stock.adobe.com

In the study, investigators assessed magnesium levels and its correlation with hemoglobin A_1c, fasting blood sugar, and postprandial blood sugar for glycemic control for patients with T2D. There was a total of 300 individuals with T2D that were not currently on medication, including magnesium supplements or metformin, and 100 age-sex-matched patients without diabetes or metabolic diseases. Investigators reported that there were no significant differences between age or gender for both groups, with 76% of those who were diabetic and 14% of those who were not diabetic showing low levels of magnesium.¹

The results also demonstrated that fasting and postprandial glucose levels were significantly higher for those who had diabetes, and insulin level and insulin resistance were also elevated in those with diabetes. The study authors reported reduced levels of magnesium for patients with diabetes (1.34±0.29 mg/dL) compared with the control patients (2.17±1.87 md/dL) (P<0.0001). Fasting blood sugar, postprandial blood sugar, hemoglobin A_1c, and glycosylated hemoglobin were significantly elevated for individuals with hypomagnesemia compared to individuals with normal magnesium levels, according to the study authors. The magnesium levels were also negatively correlated with fasting blood sugar, postprandial blood sugar, hemoglobin A_1c, glycosylated hemoglobin, and insulin.¹

T2D is frequently associated with magnesium deficiency. Magnesium helps to regulate muscle and nerve function, blood sugar, blood pressure, and making protein, bone, and DNA, according to the National Institutes of Health (NIH). Most individuals get magnesium naturally in food, such as legumes, nuts, seeds, whole grains, leafy green vegetables, and milk products. However, there are magnesium supplements for those who do not get enough in their diet. People with gastrointestinal diseases, T2D, long-term alcoholism, and older people are more likely to get too little magnesium. Symptoms of deficiency can include loss of appetite, nausea, vomiting, fatigue, and weakness.²

In a review published in World Journal of Diabetes, there has been an increased prevalence of magnesium deficits for those with T2D, especially for individuals with poorly controlled glycemia. Although magnesium deficiency can be present without hypomagnesemia, when it is present, this is indicative of a systemic magnesium deficit, according to the authors. Older patients are also more prone to hypomagnesemia, with it being closely related to metabolic control.³

Treating hypomagnesemia is important, according to the NIH. When magnesium levels are dangerously low, it can cause fatal cardiac arrhythmias, or chondrocalcinosis, and patients with acute myocardial infarction could be at higher risk of ventricular arrhythmias within the first 24 hours. Currently, symptomatic patients need to be admitted to a hospital, and asymptomatic patients can receive supplements prescribed from their physicians.

Monitoring and managing serum magnesium levels is a critical component of care for patients with T2D, as hypomagnesemia is highly prevalent in this population and closely linked to poor glycemic control and increased complications. The findings of this study underscore the importance of early detection and intervention to address magnesium deficiencies, which can be achieved through dietary modifications, supplementation, and close collaboration between patients and health care providers. Proactive management of magnesium levels not only helps to optimize glycemic outcomes but also reduces the risk of severe complications such as cardiac arrhythmias, ultimately enhancing overall patient care and quality of life.

REFERENCES

1. Ram VS, Vishnoi A, Sharma M, Jaison A, Singh N. Unveiling the Role of Magnesium: Insights into Insulin Resistance and Glycemic Control in Type 2 Diabetes. EJIFCC. 2024;35(3):189-194.

2. National Institutes of Health. Magnesium. March 22, 2021. Accessed November 26, 2024. https://ods.od.nih.gov/factsheets/Magnesium-Consumer/

3. Barbagallo M, Dominguez LJ. Magnesium and type 2 diabetes. World J Diabetes. 2015;6(10):1152-1157. doi:10.4239/wjd.v6.i10.1152

4. Gragossian A, Bashir K, Bhutta BS, et al. Hypomagnesemia. [Updated 2023 Nov 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK500003/