Study of serum magnesium in type 2 diabetes mellitus

Background: Diabetes Mellitus is one of the most common metabolic disorder and leading cause of death & disability in the world. It is due to absolute or relative insulin deficiency which leads to increased blood glucose level. Magnesium is a crucial co-factor for many enzymatic reactions involved in metabolic process. So Mg depletion has negative impact on glucose homeostasis and insulin sensitivity. Magnesium deficiency also results in failure to inhibit entry of calcium into myocardial cells, failure to extrude Ca from the cells and failure of sarcoplasmic reticulum to sequester excess Ca. Mg deficiency is typical in chronic, stable mild type 2 DM and may be a strong predisposing factor for development of complications such as retinopathy, thrombosis and hypertension and also for the development of excess cardiovascular morbidity associated with diabetes. Objectives: Aim of this study was to compare the serum Magnesium concentration in patients with type 2 Diabetes Mellitus and non-diabetes controls to assess its impact on complications. Primary objective: To estimate the diabetic profiles - FBS, PPBS and HbA1C along with Magnesium and Calcium profiles in diabetes cases and non-diabetes controls. Method: The current study population included age matched 115 patientsi.e., 75 cases who attended the Diabetic clinic and 40 controls who attended the out- patient wing of General Medicine during the study period. After getting written consent, blood samples for estimation of different parameters were collected. Serum samples were used to estimate urea, creatinine, plasma concentration of glucose (both fasting as well as postprandial), serum Magnesium, serum calcium & concentration of HbA1c in EDTA blood samples were also estimated. Result: The mean serum Mg levels were lower in diabetic patients (1.59+/- 0.242 mg/dL).The age group 61-70 reported higher the number of low Mg levels. Diabetic females showed low levels of Mg than in diabetic males. According to duration of diabetes majority of low Mg levels were seen in patients who had diabetes for >7 years. The correlative studies of magnesium with age and duration of diabetes both showed a suggestive negative correlation with r = - 0.240, p = 0.001 and r = - 0.409, p = 0.001 respectively and a moderate negative significant correlation with r values - 0.733, - 0.706 and - 0.780 respectively were obtained between serum Mg with FBS, PPBS and HbA1C. A moderate positive significant correlation with r = + 0.647 and p = 0.001 was obtained between serum Mg with serum Ca. Conclusion: Low Mg in the diabetic patient were correlated with hypertension with predominant associated complications such as Diabetic Retinopathy, Diabetic Neuropathy and Cellutitis. In hypomagnesaemia diabetic patients higher levels of HbA1C indicate the risk of development of diabetic complications. Preventing hypomagnesaemia in Diabetes Mellitus by supplementing Mg is helpful in increasing insulin sensitivity and delaying the development of diabetic complications.