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Why Magnesium Level Check Should be Part of Standard Diabetes Care?

Year 2024, Volume: 4 Issue: 1, 28 - 34, 29.01.2024
https://doi.org/10.56016/dahudermj.1408723

Abstract

Introduction: The aim of this study was to investigate the effectiveness of routine magnesium monitoring in patients with diabetes during follow-up.
Methods: A retrospective observational clinical study was conducted, encompassing 387 participants aged 18 years and older, with and without diabetes. The control group comprised patients without diabetes. The group with diabetes consisted of 237 patients (134 women, 103 men), while the control group consisted of 150 patients (85 women, 65 men). Hypomagnesemia was diagnosed at <1.6 mg/dL. The study compared the groups based on the frequency of hypomagnesemia and clinical characteristics.
Results: The prevalence of hypomagnesemia was 8.8% (13.8% in patients with diabetes, 1.3% in the control group; p=0.001), with a magnesium level of 1.93±0.24 mg/dL (1.85±0.25 mg/dL in patients with diabetes, 2.06±0.16 mg/dL in the control group; p=0.001).
The study found that the prevalence of hypomagnesemia was significantly higher in patients with diabetes, particularly those with advanced age, longer duration of diabetes, impaired glycemic control, and previous hypomagnesemia diagnosis. Moreover, the use of proton pump inhibitors (PPIs) and diuretics were more common in patients with diabetes with hypomagnesemia. Conversely, the frequency of SGLT-2 inhibitor use was lower in patients with hypomagnesemia.
Discussion: This study suggests that routine magnesium measurement should be considered as a part of standard evaluation, especially for patients with diabetes exhibiting the aforementioned risk factors, and emphasizes the significance of acknowledging PPI and diuretic usage in such cases.

References

  • Pham PC, Pham PM, Pham SV, Miller JM, Pham PT. Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol. 2007 Mar;2(2):366-73. doi: 10.2215/CJN.02960906. Epub 2007 Jan 3. PMID: 17699436.Agus ZS. Hypomagnesemia. J Am Soc Nephrol 1999; 10:1616.
  • Agus ZS. Hypomagnesemia. J Am Soc Nephrol. 1999 Jul;10(7):1616-22. doi: 10.1681/ASN.V1071616. PMID: 10405219.
  • Ahmed F, Mohammed A. Magnesium: The Forgotten Electrolyte-A Review on Hypomagnesemia. Med Sci (Basel). 2019 Apr 4;7(4):56. doi: 10.3390/medsci7040056. PMID: 30987399; PMCID: PMC6524065.
  • Waanders F, Dullaart RPF, Vos MJ, Hendriks SH, van Goor H, Bilo HJG, van Dijk PR. Hypomagnesaemia and its determinants in a contemporary primary care cohort of persons with type 2 diabetes. Endocrine. 2020 Jan;67(1):80-86. doi: 10.1007/s12020-019-02116-3. Epub 2019 Oct 24. PMID: 31650393; PMCID: PMC6968975.
  • Kurstjens S, de Baaij JH, Bouras H, Bindels RJ, Tack CJ, Hoenderop JG. Determinants of hypomagnesemia in patients with type 2 diabetes mellitus. Eur J Endocrinol. 2017 Jan;176(1):11-19. doi: 10.1530/EJE-16-0517. Epub 2016 Oct 5. PMID: 27707767.
  • Dasgupta A, Sarma D, Saikia UK. Hypomagnesemia in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2012 Nov;16(6):1000-3. doi: 10.4103/2230-8210.103020. PMID: 23226651; PMCID: PMC3510925.
  • American Diabetes Association; 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care 1 January 2019; 42 (Supplement_1): S13–S28. https://doi.org/10.2337/dc19-S002
  • Rabeea IS, Al-Gburi K, Adnan I, Hasan B, Mohammed M, Mohammed M. Pattern and Correlates of Hypomagnesemia Among Subset of Diabetes Mellitus. Curr Diabetes Rev. 2020;16(4):364-369. doi: 10.2174/1573399814666181026095236. PMID: 30362420.
  • Paladiya R, Pitliya A, Choudhry AA, Kumar D, Ismail S, Abbas M, Naz S, Kumar B, Jamil A, Fatima A. Association of Low Magnesium Level With Duration and Severity of Type 2 Diabetes. Cureus. 2021 May 27;13(5):e15279. doi: 10.7759/cureus.15279. PMID: 34194881; PMCID: PMC8235873.
  • Ramadass S, Basu S, Srinivasan AR. SERUM magnesium levels as an indicator of status of Diabetes Mellitus type 2. Diabetes Metab Syndr. 2015 Jan-Mar;9(1):42-5. doi: 10.1016/j.dsx.2014.04.024. Epub 2014 May 24. PMID: 25470649.
  • Zahra H, Berriche O, Mizouri R, Boukhayatia F, Khiari M, Gamoudi A, Lahmar I, Ben Amor N, Mahjoub F, Zayet S, Jamoussi H. Plasmatic Magnesium Deficiency in 101 Outpatients Living with Type 2 Diabetes Mellitus. Clin Pract. 2021 Oct 27;11(4):791-800. doi: 10.3390/clinpract11040095. PMID: 34842632; PMCID: PMC8628662.
  • William JH, Danziger J. Proton-pump inhibitor-induced hypomagnesemia: Current research and proposed mechanisms. World J Nephrol. 2016 Mar 6;5(2):152-7. doi: 10.5527/wjn.v5.i2.152. PMID: 26981439; PMCID: PMC4777786.
  • Tang H, Zhang X, Zhang J, Li Y, Del Gobbo LC, Zhai S, Song Y. Elevated serum magnesium associated with SGLT2 inhibitor use in type 2 diabetes patients: a meta-analysis of randomised controlled trials. Diabetologia. 2016 Dec;59(12):2546-2551. doi: 10.1007/s00125-016-4101-6. Epub 2016 Sep 15. PMID: 27628105.
  • Shah CV, Robbins TS, Sparks MA. Sodium-Glucose Cotransporter 2 Inhibitors and Management of Refractory Hypomagnesemia Without Overt Urinary Magnesium Wasting: A Report of 2 Cases. Kidney Med. 2022 Aug 12;4(10):100533. doi: 10.1016/j.xkme.2022.100533. PMID: 36185705; PMCID: PMC9519375.
  • Ray EC, Boyd-Shiwarski CR, Liu P, Novacic D, Cassiman D. SGLT2 Inhibitors for Treatment of Refractory Hypomagnesemia: A Case Report of 3 Patients. Kidney Med. 2020 Apr 18;2(3):359-364. doi: 10.1016/j.xkme.2020.01.010. PMID: 32734255; PMCID: PMC7380441.
Year 2024, Volume: 4 Issue: 1, 28 - 34, 29.01.2024
https://doi.org/10.56016/dahudermj.1408723

Abstract

References

  • Pham PC, Pham PM, Pham SV, Miller JM, Pham PT. Hypomagnesemia in patients with type 2 diabetes. Clin J Am Soc Nephrol. 2007 Mar;2(2):366-73. doi: 10.2215/CJN.02960906. Epub 2007 Jan 3. PMID: 17699436.Agus ZS. Hypomagnesemia. J Am Soc Nephrol 1999; 10:1616.
  • Agus ZS. Hypomagnesemia. J Am Soc Nephrol. 1999 Jul;10(7):1616-22. doi: 10.1681/ASN.V1071616. PMID: 10405219.
  • Ahmed F, Mohammed A. Magnesium: The Forgotten Electrolyte-A Review on Hypomagnesemia. Med Sci (Basel). 2019 Apr 4;7(4):56. doi: 10.3390/medsci7040056. PMID: 30987399; PMCID: PMC6524065.
  • Waanders F, Dullaart RPF, Vos MJ, Hendriks SH, van Goor H, Bilo HJG, van Dijk PR. Hypomagnesaemia and its determinants in a contemporary primary care cohort of persons with type 2 diabetes. Endocrine. 2020 Jan;67(1):80-86. doi: 10.1007/s12020-019-02116-3. Epub 2019 Oct 24. PMID: 31650393; PMCID: PMC6968975.
  • Kurstjens S, de Baaij JH, Bouras H, Bindels RJ, Tack CJ, Hoenderop JG. Determinants of hypomagnesemia in patients with type 2 diabetes mellitus. Eur J Endocrinol. 2017 Jan;176(1):11-19. doi: 10.1530/EJE-16-0517. Epub 2016 Oct 5. PMID: 27707767.
  • Dasgupta A, Sarma D, Saikia UK. Hypomagnesemia in type 2 diabetes mellitus. Indian J Endocrinol Metab. 2012 Nov;16(6):1000-3. doi: 10.4103/2230-8210.103020. PMID: 23226651; PMCID: PMC3510925.
  • American Diabetes Association; 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019. Diabetes Care 1 January 2019; 42 (Supplement_1): S13–S28. https://doi.org/10.2337/dc19-S002
  • Rabeea IS, Al-Gburi K, Adnan I, Hasan B, Mohammed M, Mohammed M. Pattern and Correlates of Hypomagnesemia Among Subset of Diabetes Mellitus. Curr Diabetes Rev. 2020;16(4):364-369. doi: 10.2174/1573399814666181026095236. PMID: 30362420.
  • Paladiya R, Pitliya A, Choudhry AA, Kumar D, Ismail S, Abbas M, Naz S, Kumar B, Jamil A, Fatima A. Association of Low Magnesium Level With Duration and Severity of Type 2 Diabetes. Cureus. 2021 May 27;13(5):e15279. doi: 10.7759/cureus.15279. PMID: 34194881; PMCID: PMC8235873.
  • Ramadass S, Basu S, Srinivasan AR. SERUM magnesium levels as an indicator of status of Diabetes Mellitus type 2. Diabetes Metab Syndr. 2015 Jan-Mar;9(1):42-5. doi: 10.1016/j.dsx.2014.04.024. Epub 2014 May 24. PMID: 25470649.
  • Zahra H, Berriche O, Mizouri R, Boukhayatia F, Khiari M, Gamoudi A, Lahmar I, Ben Amor N, Mahjoub F, Zayet S, Jamoussi H. Plasmatic Magnesium Deficiency in 101 Outpatients Living with Type 2 Diabetes Mellitus. Clin Pract. 2021 Oct 27;11(4):791-800. doi: 10.3390/clinpract11040095. PMID: 34842632; PMCID: PMC8628662.
  • William JH, Danziger J. Proton-pump inhibitor-induced hypomagnesemia: Current research and proposed mechanisms. World J Nephrol. 2016 Mar 6;5(2):152-7. doi: 10.5527/wjn.v5.i2.152. PMID: 26981439; PMCID: PMC4777786.
  • Tang H, Zhang X, Zhang J, Li Y, Del Gobbo LC, Zhai S, Song Y. Elevated serum magnesium associated with SGLT2 inhibitor use in type 2 diabetes patients: a meta-analysis of randomised controlled trials. Diabetologia. 2016 Dec;59(12):2546-2551. doi: 10.1007/s00125-016-4101-6. Epub 2016 Sep 15. PMID: 27628105.
  • Shah CV, Robbins TS, Sparks MA. Sodium-Glucose Cotransporter 2 Inhibitors and Management of Refractory Hypomagnesemia Without Overt Urinary Magnesium Wasting: A Report of 2 Cases. Kidney Med. 2022 Aug 12;4(10):100533. doi: 10.1016/j.xkme.2022.100533. PMID: 36185705; PMCID: PMC9519375.
  • Ray EC, Boyd-Shiwarski CR, Liu P, Novacic D, Cassiman D. SGLT2 Inhibitors for Treatment of Refractory Hypomagnesemia: A Case Report of 3 Patients. Kidney Med. 2020 Apr 18;2(3):359-364. doi: 10.1016/j.xkme.2020.01.010. PMID: 32734255; PMCID: PMC7380441.
There are 15 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Articles
Authors

Mehmet Uzunlulu 0000-0001-8754-1069

Elif Pala 0009-0009-4714-8022

Aysu Tanrivermis 0009-0004-0713-0593

Muhammed Mikdat Akbas This is me 0000-0002-8048-4281

Ender İğneci 0000-0002-8766-8382

Miraç Vural Keskinler 0000-0003-4863-9666

Early Pub Date January 27, 2024
Publication Date January 29, 2024
Submission Date December 22, 2023
Acceptance Date December 28, 2023
Published in Issue Year 2024 Volume: 4 Issue: 1

Cite

EndNote Uzunlulu M, Pala E, Tanrivermis A, Akbas MM, İğneci E, Vural Keskinler M (January 1, 2024) Why Magnesium Level Check Should be Part of Standard Diabetes Care?. DAHUDER Medical Journal 4 1 28–34.



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