The impact of magnesium on the glycemic regulation

INTRODUCTION: Magnesium is a cofactor for the phosphorylation of glucose and many other enzymatic reactions, and a deficiency can cause insulin resistance, carbohydrate intolerance, and dyslipidemia. A low serum magnesium level can lead to the development of diabetic complications, such as retinopathy, abnormal platelet function, cardiovascular disease, or hypertension. The aim of this study was to investigate the relationship between serum magnesium level and glucose regulation.
METHODS: The results of serum level tests of glucose, magnesium, glycated hemoglobin (HbA1c), and insulin values, as well as a lipid panel, performed for 256 patients between January 2016 and December 2017 were retrospectively evaluated. The patients were divided into 3 groups: nondiabetic, prediabetic, and diabetic, according to the glucose and HbA1c levels specified in the 2017 American Diabetes Association criteria. Kruskal-Wallis H and Mann-Whitney U tests were used for intergroup comparisons.
RESULTS: The patients who were nondiabetic (n=137), prediabetic (n=85), and diabetic (n=34) were aged (median [range]) 40 years (24-55), 45 years (35-58), and 48 years (30-57), respectively. There were significant differences between the nondiabetic and diabetic groups, as well as the prediabetic and diabetic groups, with respect to magnesium level (p<0.001 and p<0.001, respectively). No statistically significant difference was detected between the magnesium level of the nondiabetic and prediabetic groups. The magnesium level was significantly lower in the insulin resistant group (Homeostatic Model Assessment of Insulin Resistance [HOMA-IR] ≥2.5) (p=0.020). There was a significant negative correlation between magnesium level and glucose, HbA1c, and HOMA-IR values (r=–0.244, p<0.001; r=–0.332, p<0.001; and r=–0.162, p=0.010, respectively).
DISCUSSION AND CONCLUSION: Magnesium is a cofactor of various enzymes involved in carbohydrate oxidation and plays an important role in the transport of glucose to the cell membrane. In this study, it was observed that a low level of magnesium negatively affected glucose regulation. Magnesium-rich foods and/or oral magnesium supplementation may be beneficial in diabetic patients with reduced serum magnesium by increasing insulin sensitivity.