Abstract
Magnesium is an essential element and has a fundamental role in carbohydrate metabolism in general and in the insulin action in particular. Magnesium is involved in multiple levels in insulin secretion, binding and activity. Cellular magnesium deficiency can alter the activity of the membrane bound Na+K+ ATPase, which is involved in the maintenance of gradients of sodium and potassium and in glucose transport(1). Magnesium depletion has a negative impact on glucose homeostasis and insulin sensitivity in patients with type 2 diabetes as well as on the evolution of complications such as retinopathy, arterial atherosclerosis and nephropathy. Moreover, low serum magnesium is a strong, independent predictor of development of type 2 diabetes(2). A cross sectional study included 105 type 2 diabetic patients. Twenty nine were males (27.6%) and seventy six were females (72.4%).Their ages ranged from 30-77 with a mean of 49.7± 10.6. All patients were subjected to full clinical examination, and investigations which included: serum creatinine, HbA1c, albumin creatinine ratio and serum magnesium. Their mean BMI was 23 kg/m2 and mean waist/hip ratio was 0.9.Their mean HbA1c was 8.55 %. Of all patients, 13 of them had normal level of A/C ratio (control group) and 92 were albuminuric with a mean A/C ratio 238.26 ± 727.9 with a range of 33.7 (0.09-4700), mean s.creatinine was 1.29 ± 1.16 and their mean s.magnesium level was 2.04 ± 0.49 with a range of 1.9 (0.8-3.9). We observed significant negative correlation between A/C ratio and serum creatinine with a p-value of <0.0001. The study shows negative correlation between serum magnesium and A/C ratio(r=-0.202, p=0.039).
Highlights
Magnesium is the fourth most plentiful mineral and encountered as the second most abundant intracellular divalent cation and has been accepted as a cofactor for >300 metabolic reactions in in humans (3).The interrelationships between magnesium and carbohydrate metabolism have regained considerable interest over the last few years
The binding of insulin to its receptor does not appear to be altered by magnesium status, the ability of insulin once bound to receptor to activate tyrosine kinase is reduced in hypomagnesaemia states (6)
All patients were diagnosed as having type 2 diabetes mellitus (T2DM).The diagnosis of T2DM was made on the usual criteria(fasting blood sugar and 2 hours post prandial glucose measurement in blood)earlier during their follow up outpatient
Summary
The interrelationships between magnesium and carbohydrate metabolism have regained considerable interest over the last few years. Magnesium is a significant cofactor in a number of key enzymatic reactions and seems to play a vital role in glucose metabolism and insulin homeostasis (4). Via its interaction with ligand activated tyrosine protein kinase associated receptors, initiates a cascade of biochemical interactions that result in several physiological, biochemical and molecular events that are involved in carbohydrate, lipid and protein metabolism (5). The binding of insulin to its receptor does not appear to be altered by magnesium status, the ability of insulin once bound to receptor to activate tyrosine kinase is reduced in hypomagnesaemia states (6). Decrements in the enzymatic activities of several metabolic pathways are seen in DM patients as a result of the relative magnesium deficiency (7)
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