Oral magnesium supplementation does not affect insulin sensitivity in people with insulin-treated type 2 diabetes and a low serum magnesium: a randomised controlled trial
Drenthen LCA, de Baaij JHF, Rodwell L, van Herwaarden AE, Tack CJ, de Galan BE
Diabetologia · 21 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Nonprofit
- Diabetes Fonds
- University or hospital
- Radboud Universitair Medisch Centrum
- Nonprofit
- European Association for the Study of Diabetes
- Grants
- Diabetes Fonds (2017.81.014)
Based on 3 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2023-11-03 · Diabetologia · vol. 67 · issue 1 · pp. 52–61
- Publisher
- Springer Science+Business Media
- Cited
- 21 citations · more than 90% of similar papers · 2.6× the field average
- References
- 47 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Magnesium in Health and Disease · Parathyroid Disorders and Treatments · Potassium and Related Disorders
- Keywords
- Medicine, Type 2 diabetes, Internal medicine, Insulin, Placebo, Diabetes mellitus, Crossover study, Endocrinology, Population, Insulin resistance, Gastroenterology, Randomized controlled trial
- MeSH
- humans, diabetes mellitus, type 2, insulin resistance, magnesium, insulin, blood glucose, lipids, hypoglycemic agents, blood glucose self-monitoring, cross-over studies, double-blind method, dietary supplements, adolescent, aged, middle aged, female, male
6 authors
From NL
- Linda C. A. Drenthen · correspondingRadboud University Nijmegen; Radboud University Medical Center; Radboud Institute for Molecular Life Sciences
- Jeroen H. F. de BaaijRadboud University Nijmegen; Radboud University Medical Center
- Laura RodwellRadboud University Nijmegen; Radboud University Medical Center
- Antonius Eduard van HerwaardenRadboud University Nijmegen; Radboud University Medical Center
- Cees J. TackRadboud University Nijmegen; Radboud University Medical Center
- Bastiaan E. de GalanRadboud University Nijmegen; Radboud University Medical Center; Maastricht University
Abstract
Aims/hypothesis
Hypomagnesaemia has been associated with insulin resistance and an increased risk of type 2 diabetes. Whether magnesium supplementation improves insulin sensitivity in people with type 2 diabetes and a low serum magnesium level is unknown.
Methods
Using a randomised, double-blind (both participants and investigators were blinded to the participants' treatment sequences), placebo-controlled, crossover study design, we compared the effect of oral magnesium supplementation (15 mmol/day) for 6 weeks with that of matched placebo in individuals with insulin-treated type 2 diabetes (age ≥18 years, BMI 18-40 kg/m2, HbA1c <100 mmol/mol [11.3%], serum magnesium ≤0.79 mmol/l). Participants were recruited from the outpatient clinic and through advertisements. Randomisation to a treatment sequence order was done using a randomisation list. We used block randomisation and the two possible treatment sequences were evenly distributed among the trial population. The primary outcome was the mean glucose infusion rate during the final 30 min of a hyperinsulinaemic-euglycaemic clamp (i.e. M value). Secondary outcomes included variables of glucose control, insulin need, BP, lipid profile and hypomagnesaemia-related symptoms during follow-up.
Results
We recruited 14 participants (50% women, 100% White, mean ± SD age 67±6 years, BMI 31±5 kg/m2, HbA1c 58±9 mmol/mol [7.4±0.9%]) with insulin-treated type 2 diabetes. Magnesium supplementation increased both mean ± SEM serum magnesium level (0.75±0.02 vs 0.70±0.02 mmol/l, p=0.016) and urinary magnesium excretion (magnesium/creatinine ratio, 0.23±0.02 vs 0.15±0.02, p=0.005), as compared with placebo. The M value of the glucose clamp did not differ between the magnesium and placebo study arms (4.6±0.5 vs 4.4±0.6 mg kg-1 min-1, p=0.108). During the 6 weeks of treatment, continuous glucose monitoring outcomes, HbA1c, insulin dose, lipid profile and BP also did not differ, except for a lower HDL-cholesterol concentration after magnesium compared with placebo (1.14±0.08 vs 1.20±0.09 mmol/l, p=0.026). Symptoms potentially related to hypomagnesaemia were similar for both treatment arms.
Conclusions/interpretation
Despite an albeit modest increase in serum magnesium concentration, oral magnesium supplementation does not improve insulin sensitivity in people with insulin-treated type 2 diabetes and low magnesium levels.
Trial registration
EudraCT number 2021-001243-27.
Funding
This study was supported by a grant from the Dutch Diabetes Research Foundation (2017-81-014).
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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