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Published in: Endocrine 1/2020

Open Access 01-01-2020 | Sulfonylurea | Original Article

Hypomagnesaemia and its determinants in a contemporary primary care cohort of persons with type 2 diabetes

Authors: Femke Waanders, Robin P. F. Dullaart, Michel J. Vos, Steven H. Hendriks, Harry van Goor, Henk J. G. Bilo, Peter R. van Dijk

Published in: Endocrine | Issue 1/2020

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Abstract

Aims

Among persons with type 2 diabetes mellitus (T2DM) hypomagnesaemia has been reported in 14–48% of patients. This may be of significance given the emerging associations of hypomagnesaemia with glucometabolic disturbances and possibly even complications. We assessed the prevalence of hypomagnesaemia and its determinants, in a well-defined cohort of persons with T2DM treated in primary care.

Methods

Observational cohort study among persons with T2DM treated in primary care in the Northeast of the Netherlands. Magnesium was measured using a colorimetric endpoint assay (Roche). Hypomagnesaemia was defined as a serum magnesium level <0.70 mmol/L. Pearson correlations were performed to correlate variables with serum magnesium. Next, a stepwise backward regression model was made.

Results

Data of 929 persons (55% male) with a mean age of 65 (± 10) years, diabetes duration 6.5 [3.0–10.1] years, and HbA1c concentration 6.7 (± 0.7)% (50 (± 9) mmol/mol) were analysed. Serum magnesium was 0.79 (± 0.08) mmol/L. The percentage of persons with magnesium deficiency was 9.6%. Age, diabetes duration, BMI, HbA1c, use of metformin, sulfonylurea derivatives, and DPP4 inhibitors were negatively associated with magnesium concentrations. In contrast, LDL cholesterol and serum creatinine were positively associated serum magnesium.

Conclusions

Hypomagnesaemia was present in 9.6% of T2DM patients treated in primary care. This percentage is remarkably lower than reported previously, possibly due to the unselected nature of our population. Concerning T2DM-related factors, only BMI, HbA1c and the use of metformin, sulfonylurea derivatives and DPP4 inhibitors correlated negatively with magnesium concentrations.
Literature
3.
go back to reference J.C. Schutten, A.W. Gomes-Neto., G. Navis, et al. Lower plasma magnesium, measured by nuclear magnetic resonance spectroscopy, is associated with increased risk of developing type 2 diabetes mellitus in women: results from a Dutch prospective cohort study. J. Clin. Med. 8, 1–16 (2019). https://doi.org/10.3390/jcm8020169 J.C. Schutten, A.W. Gomes-Neto., G. Navis, et al. Lower plasma magnesium, measured by nuclear magnetic resonance spectroscopy, is associated with increased risk of developing type 2 diabetes mellitus in women: results from a Dutch prospective cohort study. J. Clin. Med. 8, 1–16 (2019). https://​doi.​org/​10.​3390/​jcm8020169
5.
go back to reference J.L. Nadler, T. Buchanan, R. Natarajan et al. Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertens. Dallas Tex. 1979 21, 1024–1029 (1993) J.L. Nadler, T. Buchanan, R. Natarajan et al. Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertens. Dallas Tex. 1979 21, 1024–1029 (1993)
8.
go back to reference J. Ma, A.R. Folsom, S.L. Melnick et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. Atherosclerosis Risk in Communities Study. J. Clin. Epidemiol. 48, 927–940 (1995)CrossRef J. Ma, A.R. Folsom, S.L. Melnick et al. Associations of serum and dietary magnesium with cardiovascular disease, hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC study. Atherosclerosis Risk in Communities Study. J. Clin. Epidemiol. 48, 927–940 (1995)CrossRef
9.
go back to reference M. de Lordes Lima, T. Cruz, J.C. Pousada et al. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 21, 682–686 (1998)CrossRef M. de Lordes Lima, T. Cruz, J.C. Pousada et al. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 21, 682–686 (1998)CrossRef
10.
go back to reference P. McNair, M.S. Christensen, C. Christiansen et al. Renal hypomagnesaemia in human diabetes mellitus: its relation to glucose homeostasis. Eur. J. Clin. Investig. 12, 81–85 (1982)CrossRef P. McNair, M.S. Christensen, C. Christiansen et al. Renal hypomagnesaemia in human diabetes mellitus: its relation to glucose homeostasis. Eur. J. Clin. Investig. 12, 81–85 (1982)CrossRef
12.
go back to reference N. Mikhail, K. Ehsanipoor, Ionized serum magnesium in type 2 diabetes mellitus: its correlation with total serum magnesium and hemoglobin A1c levels. South Med. J. 92, 1162–1166 (1999)CrossRef N. Mikhail, K. Ehsanipoor, Ionized serum magnesium in type 2 diabetes mellitus: its correlation with total serum magnesium and hemoglobin A1c levels. South Med. J. 92, 1162–1166 (1999)CrossRef
17.
go back to reference W.T. Friedewald, R.I. Levy, D.S. Fredrickson, Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin. Chem. 18, 499–502 (1972)PubMed W.T. Friedewald, R.I. Levy, D.S. Fredrickson, Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin. Chem. 18, 499–502 (1972)PubMed
23.
go back to reference C. Schnack, I. Bauer, P. Pregant et al. Hypomagnesaemia in type 2 (non-insulin-dependent) diabetes mellitus is not corrected by improvement of long-term metabolic control. Diabetologia 35, 77–79 (1992)CrossRef C. Schnack, I. Bauer, P. Pregant et al. Hypomagnesaemia in type 2 (non-insulin-dependent) diabetes mellitus is not corrected by improvement of long-term metabolic control. Diabetologia 35, 77–79 (1992)CrossRef
Metadata
Title
Hypomagnesaemia and its determinants in a contemporary primary care cohort of persons with type 2 diabetes
Authors
Femke Waanders
Robin P. F. Dullaart
Michel J. Vos
Steven H. Hendriks
Harry van Goor
Henk J. G. Bilo
Peter R. van Dijk
Publication date
01-01-2020
Publisher
Springer US
Published in
Endocrine / Issue 1/2020
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-019-02116-3

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