Are vascular complications in type 2 diabetes mellitus patients influenced by serum magnesium levels?

Abstract

Introduction:Diabetes mellitus is a highly prevalent disease worldwide. Diabetes and itscomplications are a significant cause of mortality, morbidity and increased burden tocountry’s health sector. Many microelements/Micronutrients have been evaluated as potentialpreventive and therapeutic options in diabetes mellitus. Magnesium (Mg) deficiency is saidto be associated with poor glycaemic control, and increased incidence of vascular complications. The present study is undertaken with an aim to estimate prevalence of hypomagnesaemia in patients with type 2 DM and to correlate the serum magnesium concentrations with micro vascular and macro vascular complications of diabetes.Material and Methods:140 patients of type 2 Diabetes mellitus attending JSS Hospital were grouped into twostudy groups. 100 diabetics with vascular complications including coronary artery disease, peripheral vascular disease, diabetic renal disease, diabetic retinopathy (Study group I; cases) and 40 diabetics without vascular complications (Study group II;controls).Blood samples were collected for measurement of fasting blood glucose and serum magnesium. Post prandial blood sugar was measured 2hours after standard meal. Blood urea, serum creatinine and urinary albumin were estimated. Serum magnesium was estimated by Xylidyl blue method. HbA1C estimated was carried out by modified calorimetric method. 2D echo, arterial Doppler,ENMG were done in selected cases.Results:Hypomagnesaemia (defined as serum magnesium concentration <1.7 mg/dl) wasfound in 58 patients. No significant difference was found in rate of hypomagnesemiain men and women (31.88% and 41.99% respectively). The duration of diabetes didnot significantly predict serum magnesium concentration. A higher prevalence of hypomagnesaemia was observed in patients treated with insulin. However, the difference was statistically insignificant (p value = 0.5).Serum magnesium concentration showed no significant correlation with poorglycemic control i.e. HbA1C should be > 7%, (p value = 0.2), through a higher prevalence of hypomagnesaemia was found in patients having poor glycemic control(P<0.0001).Conclusion:In our study, we found that Magnesium levels were significantly associated with micro vascular complications, especially diabetic retinopathy. Therefore, screening for serum Mg levels in Type 2 diabetes and its correction may help to prevent further diabetic complications. No significant association was noted between serum magnesium and other factors like age, sex, duration of diabetes, mode of diabetic treatment.