Many epidemiological studies have demonstrated that lower serum magnesium levels were associated with an increased risk for Type 2 diabetes (T2D). However, association studies have not determined whether low serum magnesium causes diabetes or diabetes causes low serum magnesium levels (it has been observed patients with hyperglycemia show increased urinary excretion of magnesium1).
Researchers involved in the Rotterdam Study—a prospective population-based cohort study that has been ongoing since 1990 at the Erasmus Medical Center in Rotterdam—recently explored the relationship between serum magnesium levels and prediabetes. If low serum magnesium is due to T2D, then it would be unlikely to find such an association in prediabetes as blood glucose levels in those patients are not high enough to result in increased urinary excretion of magnesium.
Yet, after following more than 7000 Rotterdam Study participants over a median of nearly 6 years, the researchers found that low serum magnesium levels were associated with an increased risk of prediabetes, with comparable risk estimates to that of T2D.2 Further, they found that common genetic variation in magnesium-regulating genes (including genes that regulate magnesium reabsorption and transport) influenced diabetes risk, and this risk was mediated through alterations in serum magnesium levels. “Both findings support a potential causal role of magnesium in the development of T2D,” the study authors concluded.
The study results were published in the journal Diabetologia (February 2017).
Why is this clinically important?
- T2D prevention is crucial, for nearly one out of three people in the U.S. will develop T2D during their life3
- Early diagnosis of glucose impairment (prediabetes) and subsequent patient workup should include serum magnesium assessment and follow up supplementation and management as required
- Magnesium is involved in glucose transport, insulin sensitivity and insulin secretion. Yet, 1 out of every 2 Americans 1 year and older had inadequate intakes of magnesium4
The findings from the Rotterdam Study reinforced that magnesium is a potential modifiable factor in the prevention of T2D. Magnesium supplementation may help Americans meet recommended dietary intakes for magnesium, according to national surveys and cohort studies.5-7
- Gommers LM, Hoenderop JG, Bindels RJ, de Baaij JH. Hypomagnesemia in Type 2 Diabetes: A Vicious Circle? Diabetes 2016;65:3-13.
- Kieboom BC, Ligthart S, Dehghan A, et al. Serum magnesium and the risk of prediabetes: a population-based cohort study. Diabetologia 2017.
- Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. JAMA 2003;290:1884-90.
- Moshfegh A, Goldman J, Ahuja J, Rhodes D, LaComb R. What We Eat in America, NHANES 2005-2006: Usual nutrient intakes from food and water compared to 1997 Dietary Reference Intakes for vitamin D, calcium, phosphorus, and magnesium. In: U.S. Department of Agriculture ARS, ed.2009.
- Burnett-Hartman AN, Fitzpatrick AL, Gao K, Jackson SA, Schreiner PJ. Supplement use contributes to meeting recommended dietary intakes for calcium, magnesium, and vitamin C in four ethnicities of middle-aged and older Americans: the Multi-Ethnic Study of Atherosclerosis. J Am Diet Assoc 2009;109:422-9.
- Bailey RL, Fulgoni VL, 3rd, Keast DR, Dwyer JT. Dietary supplement use is associated with higher intakes of minerals from food sources. Am J Clin Nutr 2011;94:1376-81.
- Ford ES, Mokdad AH. Dietary magnesium intake in a national sample of US adults. J Nutr 2003;133:2879-82.