Association of Magnesium Status with Poor Glycemic Control and Microangiopathic Complications (Neuropathy and Nephropathy) in Diabetic Patients in Dakar
Advances in Biochemistry
Volume 7, Issue 3, September 2019, Pages: 59-64
Received: Sep. 3, 2019;
Accepted: Sep. 27, 2019;
Published: Oct. 14, 2019
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Nènè Oumou Kesso Barry, Laboratory of Pharmaceutical Biochemistry, University Cheikh Anta Diop, Dakar, Senegal; Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
Michel Assane Ndour, Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal
Moustapha Djite, Laboratory of Pharmaceutical Biochemistry, University Cheikh Anta Diop, Dakar, Senegal; Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
Demba Diedhiou, Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal
Pape Matar Kandji, Laboratory of Pharmaceutical Biochemistry, University Cheikh Anta Diop, Dakar, Senegal; Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
El Hadji Malick Ndour, Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
Gueye-tall Fatou, Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
Aissatou Diallo, Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal
Ahmed Limane Barage, Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal
Maimouna Ndour Mbaye, Department of Internal Medicine, Abass Ndao Hospital Center, Dakar, Senegal
Philomène Lopez Sall, Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
Papa Madieye Gueye, Laboratory of Pharmaceutical Biochemistry, University Cheikh Anta Diop, Dakar, Senegal; Laboratory of Biochemistry, University Hospital Fann, Dakar, Senegal
Low serum magnesium level has been shown to be associated with diabetes mellitus and its complications. The objective of this study was to determine the magnesium status in our study population and its association with glycemic control and microangiopathic complications particularly neuropathy and nephropathy. This was a cross sectional and prospective study conducted among patients received as part of their follow-up at the Marc Sankalé center of the Abass Ndao hospital in Dakar. For each patient, blood samples and 24h urine collection were performed. Hypomagnesemia was defined for Mg concentrations <17 mg/L and statistical analysis was performed using the XLSTAT 2018 software. A total of 106 diabetic patients were enrolled consisting of 93 type 2 diabetics and 13 type 1 diabetics. Eighty percent of patients had hypomagnesemia compared to 20% who had normal magnesium levels. We found a significantly higher mean HbA1c level in the group of hypomagnesemic patients compared to patients with normal magnesium levels (p = 0.02) and significant negative correlation between magnesium and HbA1c (r = - 0.20, p = 0.03). The frequencies of neuropathy and nephropathy were comparable between the two groups with respectively p = 0.12 and p = 0.28. Our study shows a high frequency of hypomagnesemia in both type 1 and type 2 diabetes and a significant correlation of this hypomagnesemia with poor glycemic control. No association has been found between magnesium and the microangiopathic complications, but it nevertheless alerts clinicians to the possible need for magnesium supplementation in the management of diabetic patients.
Nènè Oumou Kesso Barry,
Michel Assane Ndour,
Pape Matar Kandji,
El Hadji Malick Ndour,
Ahmed Limane Barage,
Maimouna Ndour Mbaye,
Philomène Lopez Sall,
Papa Madieye Gueye,
Association of Magnesium Status with Poor Glycemic Control and Microangiopathic Complications (Neuropathy and Nephropathy) in Diabetic Patients in Dakar, Advances in Biochemistry.
Vol. 7, No. 3,
2019, pp. 59-64.
OMS. Rapport mondial sur le diabète 2016.
International Diabetes Federetion (IDF). IDF diabetes atlas, 6th edn Brussels, Belgium 2013.
Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes research and clinical practice 2011; 94 (3): 311-21.
Martin HE, Wertman M. Serum potassium, magnesium, and calcium levels in diabetic acidosis. The Journal of clinical investigation 1947; 26 (2): 217-28.
Pham PCT, Pham P-MT, Pham SV, Miller JM, Pham PTT. Hypomagnesemia in patients with type 2 diabetes. Clinical journal of the American Society of Nephrology 2007; 2 (2): 366-73.
Mather H, Nisbet JA, Burton G, Poston G, Bland J, Bailey PA, et al. Hypomagnesaemia in diabetes. Clinica Chimica Acta 1979; 95 (2): 235-42.
Schnack C, Bauer I, Pregant P, Hopmeier P, Schernthaner G. Hypomagnesaemia in type 2 (non-insulin-dependent) diabetes mellitus is not corrected by improvement of long-term metabolic control. Diabetologia. 1992; 35 (1): 77-9.
Ramadass S, Basu S, Srinivasan A. Serum magnesium levels as an indicator of status of Diabetes Mellitus type 2 Diabetes & Metabolic Syndrome. Clinical Research & Reviews 2015; 9 (1): 42-5.
Ma J, Folsom AR, Melnick SL, Eckfeldt JH, Sharrett AR, Nabulsi AA, et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. Journal of clinical epidemiology 1995; 48 (7): 927-40.
Del Gobbo LC, Song Y, Poirier P, Dewailly E, Elin RJ, Egeland GM. Low serum magnesium concentrations are associated with a high prevalence of premature ventricular complexes in obese adults with type 2 diabetes. Cardiovascular diabetology 2012; 11 (1): 23.
Al T, Tzadegan IH. The Determination Of Zinc And Magnesium For Diabetics And The Evaluation Of Results. Hiiyen Ve Deneysel Biyoloii Del-Gisi 1978; 103: 118.
Dasgupta A, Sarma D, Saikia UK. Hypomagnesemia in type 2 diabetes mellitus. Indian journal of endocrinology and metabolism 2012; 16 (6): 1000.
Arpaci D, Tocoglu A, Ergenc H, Korkmaz S, Ucar A, Tamer A. Associations of serum magnesium levels with diabetes mellitus and diabetic complications. Hippokratia 2015; 19 (2): 153.
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. Journal of diabetes research 2016.
Barbagallo M, Di Bella G, Brucato V, D’Angelo D, Damiani P, Monteverde A, et al. Serum ionized magnesium in diabetic older persons. Metabolism 2014; 63 (4): 502-9.
Shahbah D, El Naga AA, Hassan T, Zakaria M, Beshir M, Al Morshedy S, et al. Status of serum magnesium in Egyptian children with type 1 diabetes and its correlation to glycemic control and lipid profile. Medicine 2016; 95 (47).
Lin CC, Tsweng GJ, Lee CF, Chen BH, Huang YL. Magnesium, zinc, and chromium levels in children, adolescents, and young adults with type 1 diabetes. Clinical Nutrition 2016; 35 (4): 880-4.
Salmonowicz B, Krzystek-Korpacka M, Noczynska A. Trace elements, magnesium, and the efficacy of antioxidant systems in children with type 1 diabetes mellitus and in their siblings. Adv Clin Exp Med. 2014; 23 (2): 259-68.
Odusan OO, Familoni OB, Odewabi AO, Idowu AO, Adekolade AS. Patterns and correlates of serum magnesium levels in subsets of type 2 diabetes mellitus patients in Nigeria. Indian journal of endocrinology and metabolism 2017; 21 (3): 439.
Pokharel DR, Khadka D, Sigdel M, Yadav NK, Kafle R, Sapkota RM, et al. Association of serum magnesium level with poor glycemic control and renal functions in Nepalese patients with type 2 diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2017; 11: S417-S23.
Kim DJ, Xun P, Liu K, Loria C, Yokota K, Jacobs DR, et al. Magnesium intake in relation to systemic inflammation, insulin resistance, and the incidence of diabetes. Diabetes care 2010.
Sjögren A, Florén CH, Nilsson A. Magnesium deficiency in IDDM related to level of glycosylated hemoglobin. Diabetes 1986; 35: 459–63.
Sales CH, Pedrosa LF, Lima JG, Lemos TM, Colli C. Influence of magnesium status and magnesium intake on the blood glucose control in patients with type 2 diabetes. Clin Nutr. 2011; 30: 359–64.
Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in type 2 diabetes: a vicious circle? Diabetes 2016; 65 (1): 3-13.
Gylfe E. Insulin secretagogues induce Ca2+-like changes in cytoplasmic Mg2+ in pancreatic β-cells. Biochimica et Biophysica Acta (BBA)-Molecular Cell Research 1990; 1055 (1): 82-6.
Romani AM, Matthews VD, Scarpa A. Parallel stimulation of glucose and Mg2+ accumulation by insulin in rat hearts and cardiac ventricular myocytes. Circulation Research 2000; 86 (3): 326-33.
Takaya J, Higashino H, Kobayashi Y. Intracellular magnesium and insulin resistance. Magnesium research 2004; 17 (2): 126-36.
Hruby A, Ngwa JS, Renström F, Wojczynski MK, Ganna A, Hallmans G, et al. Higher Magnesium Intake Is Associated with Lower Fasting Glucose and Insulin, with No Evidence of Interaction with Select Genetic Loci, in a Meta-Analysis of 15 charge Consortium Studies1. The Journal of nutrition. 2013; 143 (3): 345-53.
Larsson S, Wolk A. Magnesium intake and risk of type 2 diabetes: a meta-analysis. Journal of internal medicine 2007; 262 (2): 208-14.
Song Y, He K, Levitan E, Manson J, Liu S. Effects of oral magnesium supplementation on glycaemic control in Type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Diabetic Medicine 2006; 23 (10): 1050-6.
Reverter JL, Pizarro E, Sentí M, Pedro-Botet J, Rubiés-Prat J, Romero R, et al. Relationship Between Lineprotein Profile and Urinary Albumin Excretion in Type II Diabetic Patients With Stable Metabolic Control. Diabetes Care 1994; 17 (3): 189-94.
Altura BM, Altura BT. Magnesium and cardiovascular biology: an important link between cardiovascular risk factors and atherogenesis. Cellular & molecular biology research 1995; 41 (5): 347-59.
Guerrero-Romero F, Rodrı́guez-Morán M. Hypomagnesemia is linked to low serum HDL-cholesterol irrespective of serum glucose values. Journal of Diabetes and its Complications 2000; 14 (5): 272-6.
Maier JA. Endothelial cells and magnesium: implications in atherosclerosis. Clinical science 2012; 122 (9): 397-407.
De Leeuw I, Engelen W, De Block C, Van Gaal L. Long term magnesium supplementation influences favourably the natural evolution of neuropathy in Mg-depleted type 1 diabetic patients (T1dm). Magnesium research 2004; 17 (2): 109-14.
Mirrahimi B, Hamishehkar H, Ahmadi A, Mirjalili MR, Aghamohamadi M, Najafi A, et al. The efficacy of magnesium sulfate loading on microalbuminuria following SIRS: One step forward in dosing. Journal of Pharmaceutical Sciences 2012; 20 (1): 74.
Zargar AH, Bashir MI, Masoodi SR, Laway BA, Wani AI, Khan AR, et al. Copper, zinc and magnesium levels in type-1 diabetes mellitus. Saudi Med J 2002; 23 (5): 539-42.
Galli-Tsinopoulou A, Maggana I, Kyrgios I, Mouzaki K, Grammatikopoulou MG, Stylianou C, et al. Association between magnesium concentration and HbA1c in children and adolescents with type 1 diabetes mellitus. Journal of diabetes 2014; 6 (4): 369-77.