Association of Serum Magnesium Levels with Glycemic Control and Diabetic Complications in Type 2 Diabetes Mellitus: A Cross-Sectional Study

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder that poses a major global health burden. Magnesium, a vital intracellular cation, plays an important role in glucose metabolism and insulin function. Recent studies have indicated a possible link between hypomagnesemia and poor glycemic control as well as diabetic complications, yet serum magnesium levels are often not routinely assessed in T2DM patients. This study aimed to evaluate serum magnesium levels in T2DM patients and determine their association with glycemic control and diabetic complications.

Methodology: A prospective cross-sectional study was conducted at R L Jalappa Hospital over a period of one month, including 70 patients with T2DM aged 18 years and above. Patients receiving diuretics, with chronic diarrhea, malabsorption, or sepsis were excluded. Serum magnesium levels were estimated using the Xylidyl Blue colorimetric method. Glycemic control was assessed using glycated hemoglobin (HbA1c), fasting blood sugar (FBS), and postprandial blood sugar (PPBS). Diabetic complications including neuropathy, nephropathy, and retinopathy were evaluated through clinical assessments and relevant investigations. Data were analyzed using SPSS v22, with p-values <0.05 considered statistically significant.

Results: Among the 70 patients, 28 (40%) had hypomagnesemia. The mean HbA1c was significantly higher in the hypomagnesemic group (8.75 ± 1.57%) compared to the normomagnesemic group (7.29 ± 1.20%) (p < 0.001). Similarly, RBG, SGPT, SGOT, potassium, and total leukocyte counts were significantly elevated in the hypomagnesemic group (p < 0.05). A statistically significant association was observed between low serum magnesium and poor glycemic control, with 78.8% of patients with HbA1c >7% being hypomagnesemic (p < 0.001). Non-proliferative diabetic retinopathy (NPDR) and nephropathy were significantly more common in patients with hypomagnesemia (p = 0.001). Although the incidence of proliferative diabetic retinopathy (PDR) was higher in this group, it did not reach statistical significance (p = 0.064).

Conclusion: Hypomagnesemia is common in T2DM patients and is significantly associated with poor glycemic control and an increased risk of microvascular complications, particularly NPDR and nephropathy. These findings underscore the importance of routine serum magnesium monitoring in the management of T2DM. Identifying and correcting magnesium deficiency could contribute to better glycemic outcomes and reduce the burden of diabetic complications. Future longitudinal and interventional studies are needed to explore the potential benefits of magnesium supplementation in diabetes care.