Clinical Nutrition Research

The Korean Society of Clinical Nutrition (한국임상영양학회)
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The Effects of Magnesium Supplementation on Serum Magnesium and Calcium Concentration in Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Mohammad Zamani (Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences) ;
  • Neda Haghighat (Laparoscopy Research Center, Shiraz University of Medical Sciences)
  • Received : 2022.02.12
  • Accepted : 2022.04.19
  • Published : 2022.04.30
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Abstract

The aim of this systematic review and meta-analysis was to summarize all the existing randomized controlled trials (RCTs) evidence and to evaluate the effects of magnesium supplementation on serum magnesium, calcium and urinary magnesium concentrations in patients with type 2 diabetes compared with the control. Two independent authors systematically searched online databases including Embase, Scopus, PubMed, and Web of Science from inception until 30th January 2022. RCTs complying with the inclusion criteria were included in this meta-analysis. The heterogeneity among the included studies was assessed using Cochrane's Q test and I-square (I2) statistic. Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size. Sixteen trials were included in this meta-analysis. Serum magnesium (mean difference, 0.15 mg/dL; 95% confidence interval [CI], 0.06 to 0.23; p = 0.001) and urinary magnesium (WMD, 1.99 mg/dL; 95% CI, 0.36 to 3.62; p = 0.017) concentrations were significantly increased after magnesium supplementation when compared with the control group. However, magnesium supplementation did not have any significant effect on serum calcium (WMD, -0.09 mg/dL; 95% CI, -0.27 to 0.08; p = 0.294) level when compared with the control group. This meta-analysis demonstrated that magnesium supplementation significantly increased Serum magnesium levels which may have played an indirect role in improved clinical symptoms in patients with type 2 diabetes.

Keywords

References

  1. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013;36 Suppl 1:S67-74.
  2. Ali A, Iqbal F, Taj A, Iqbal Z, Amin MJ, Iqbal QZ. Prevalence of microvascular complications in newly diagnosed patients with type 2 diabetes. Pak J Med Sci 2013;29:899-902.
  3. Yajnik CS, Smith RF, Hockaday TD, Ward NI. Fasting plasma magnesium concentrations and glucose disposal in diabetes. Br Med J (Clin Res Ed) 1984;288:1032-4.
  4. Paolisso G, Scheen A, Cozzolino D, Di Maro G, Varricchio M, D'Onofrio F, Lefebvre PJ. Changes in glucose turnover parameters and improvement of glucose oxidation after 4-week magnesium administration in elderly noninsulin-dependent (type II) diabetic patients. J Clin Endocrinol Metab 1994;78:1510-4.
  5. Paolisso G, Passariello N, Pizza G, Marrazzo G, Giunta R, Sgambato S, Varricchio M, D'Onofrio F. Dietary magnesium supplements improve B-cell response to glucose and arginine in elderly non-insulin dependent diabetic subjects. Acta Endocrinol (Copenh) 1989;121:16-20.
  6. Haghighat N, Ashtary-Larky D, Bagheri R, Mahmoodi M, Rajaei M, Alipour M, Kooti W, Aghamohammdi V, Wong A. The effect of 12 weeks of euenergetic high-protein diet in regulating appetite and body composition of women with normal-weight obesity: a randomised controlled trial. Br J Nutr 2020;124:1044-51.
  7. Asbaghi O, Ashtary-Larky D, Bagheri R, Moosavian SP, Olyaei HP, Nazarian B, Rezaei Kelishadi M, Wong A, Candow DG, Dutheil F, Suzuki K, Alavi Naeini A. Folic acid supplementation improves glycemic control for diabetes prevention and management: a systematic review and dose-response meta-analysis of randomized controlled trials. Nutrients 2021;13:2355.
  8. Asbaghi O, Fouladvand F, Gonzalez MJ, Ashtary-Larky D, Choghakhori R, Abbasnezhad A. Effect of green tea on glycemic control in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Syndr 2021;15:23-31.
  9. Asbaghi O, Naeini F, Ashtary-Larky D, Moradi S, Zakeri N, Eslampour E, Kelishadi MR, Naeini AA. Effects of chromium supplementation on lipid profile in patients with type 2 diabetes: a systematic review and dose-response meta-analysis of randomized controlled trials. J Trace Elem Med Biol 2021;66:126741.
  10. Haghighat N, Mohammadshahi M, Shayanpour S, Haghighizadeh MH. Effects of synbiotics and probiotics supplementation on serum levels of endotoxin, heat shock protein 70 antibodies and inflammatory markers in hemodialysis patients: a randomized double-blinded controlled trial. Probiotics Antimicrob Proteins 2020;12:144-51.
  11. Vafa M, Haghighat N, Moslehi N, Eghtesadi S, Heydari I. Effect of Tocotrienols enriched canola oil on glycemic control and oxidative status in patients with type 2 diabetes mellitus: a randomized double-blind placebo-controlled clinical trial. J Res Med Sci 2015;20:540-7.
  12. Paolisso G, Sgambato S, Gambardella A, Pizza G, Tesauro P, Varricchio M, D'Onofrio F. Daily magnesium supplements improve glucose handling in elderly subjects. Am J Clin Nutr 1992;55:1161-7.
  13. Veronese N, Watutantrige-Fernando S, Luchini C, Solmi M, Sartore G, Sergi G, Manzato E, Barbagallo M, Maggi S, Stubbs B. Effect of magnesium supplementation on glucose metabolism in people with or at risk of diabetes: a systematic review and meta-analysis of double-blind randomized controlled trials. Eur J Clin Nutr 2016;70:1354-9.
  14. de Lordes Lima M, Cruz T, Pousada JC, Rodrigues LE, Barbosa K, Cangucu V. The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 1998;21:682-6.
  15. Guerrera MP, Volpe SL, Mao JJ. Therapeutic uses of magnesium. Am Fam Physician 2009;80:157-62.
  16. Nadler JL, Buchanan T, Natarajan R, Antonipillai I, Bergman R, Rude R. Magnesium deficiency produces insulin resistance and increased thromboxane synthesis. Hypertension 1993;21:1024-9.
  17. Chaudhary DP, Sharma R, Bansal DD. Implications of magnesium deficiency in type 2 diabetes: a review. Biol Trace Elem Res 2010;134:119-29.
  18. de Valk HW, Verkaaik R, van Rijn HJ, Geerdink RA, Struyvenberg A. Oral magnesium supplementation in insulin-requiring type 2 diabetic patients. Diabet Med 1998;15:503-7.
  19. Suh S, Bae JC, Jin SM, Jee JH, Park MK, Kim DK, Kim JH. Serum calcium changes and risk of type 2 diabetes mellitus in Asian population. Diabetes Res Clin Pract 2017;133:109-14.
  20. Rodriguez-Moran M, Guerrero-Romero F. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care 2003;26:1147-52.
  21. Guerrero-Romero F, Rodriguez-Moran M. The effect of lowering blood pressure by magnesium supplementation in diabetic hypertensive adults with low serum magnesium levels: a randomized, double-blind, placebo-controlled clinical trial. J Hum Hypertens 2009;23:245-51.
  22. ELDerawi WA, Naser IA, Taleb MH, Abutair AS. The effects of oral magnesium supplementation on glycemic response among type 2 diabetes patients. Nutrients 2018;11:44.
  23. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.
  24. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA; Cochrane Bias Methods GroupCochrane Statistical Methods Group. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343 oct18 2:d5928.
  25. Iorio A, Spencer FA, Falavigna M, Alba C, Lang E, Burnand B, McGinn T, Hayden J, Williams K, Shea B, Wolff R, Kujpers T, Perel P, Vandvik PO, Glasziou P, Schunemann H, Guyatt G. Use of GRADE for assessment of evidence about prognosis: rating confidence in estimates of event rates in broad categories of patients. BMJ 2015;350:h870.
  26. Corica F, Allegra A, Di Benedetto A, Giacobbe MS, Romano G, Cucinotta D, Buemi M, Ceruso D. Effects of oral magnesium supplementation on plasma lipid concentrations in patients with non-insulin-dependent diabetes mellitus. Magnes Res 1994;7:43-7.
  27. Eibl NL, Kopp HP, Nowak HR, Schnack CJ, Hopmeier PG, Schernthaner G. Hypomagnesemia in type II diabetes: effect of a 3-month replacement therapy. Diabetes Care 1995;18:188-92.
  28. Barragan-Rodriguez L, Rodriguez-Moran M, Guerrero-Romero F. Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes: a randomized, equivalent trial. Magnes Res 2008;21:218-23.
  29. Barbagallo M, Dominguez LJ, Galioto A, Pineo A, Belvedere M. Oral magnesium supplementation improves vascular function in elderly diabetic patients. Magnes Res 2010;23:131-7.
  30. Navarrete-Cortes A, Ble-Castillo JL, Guerrero-Romero F, Cordova-Uscanga R, Juarez-Rojop IE, Aguilar-Mariscal H, Tovilla-Zarate CA, Lopez-Guevara MR. No effect of magnesium supplementation on metabolic control and insulin sensitivity in type 2 diabetic patients with normomagnesemia. Magnes Res 2014;27:48-56.
  31. Solati M, Ouspid E, Hosseini S, Soltani N, Keshavarz M, Dehghani M. Oral magnesium supplementation in type II diabetic patients. Med J Islam Repub Iran 2014;28:67.
  32. Singh YR, Verma S, Agrawal D, Singh B, Bhardwaj A, Agrawal GA. A study of magnesium supplementation on glycemic control in patients of type-2 diabetes mellitus. Indian J Clin Anat Physiol 2015;2:26-30.
  33. Razzaghi R, Pidar F, Momen-Heravi M, Bahmani F, Akbari H, Asemi Z. Magnesium supplementation and the effects on wound healing and metabolic status in patients with diabetic foot ulcer: a randomized, double-blind, placebo-controlled trial. Biol Trace Elem Res 2018;181:207-15.
  34. Rashvand S, Mobasseri M, Tarighat-Esfanjani A. The effects of choline and magnesium co-supplementation on metabolic parameters, inflammation, and endothelial dysfunction in patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. J Am Coll Nutr 2019;38:714-21.
  35. Sadeghian M, Azadbakht L, Khalili N, Mortazavi M, Esmaillzadeh A. Oral Magnesium Supplementation Improved Lipid Profile but Increased Insulin Resistance in Patients with Diabetic Nephropathy: a Double-Blind Randomized Controlled Clinical Trial. Biol Trace Elem Res 2020;193:23-35.
  36. Talari HR, Zakizade M, Soleimani A, Bahmani F, Ghaderi A, Mirhosseini N, Eslahi M, Babadi M, Mansournia MA, Asemi Z. Effects of magnesium supplementation on carotid intima-media thickness and metabolic profiles in diabetic haemodialysis patients: a randomised, double-blind, placebo-controlled trial. Br J Nutr 2019;121:809-17.
  37. Asbaghi O, Moradi S, Kashkooli S, Zobeiri M, Nezamoleslami S, Hojjati Kermani MA, Lazaridi AV, Miraghajani M. The effects of oral magnesium supplementation on glycaemic control in patients with type 2 diabetes: a systematic review and dose-response meta-analysis of controlled clinical trials. Br J Nutr. Forthcoming 2022.
  38. Asbaghi O, Moradi S, Nezamoleslami S, Moosavian SP, Hojjati Kermani MA, Lazaridi AV, Miraghajani M. The Effects of magnesium supplementation on lipid profile among type 2 diabetes patients: a systematic review and meta-analysis of randomized controlled trials. Biol Trace Elem Res 2021;199:861-73.
  39. Asbaghi O, Hosseini R, Boozari B, Ghaedi E, Kashkooli S, Moradi S. The Effects of Magnesium Supplementation on Blood Pressure and Obesity Measure Among Type 2 Diabetes Patient: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Biol Trace Elem Res 2021;199:413-24.
  40. Grober U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients 2015;7:8199-226.
  41. Gunther T. The biochemical function of Mg2+ in insulin secretion, insulin signal transduction and insulin resistance. Magnes Res 2010;23:5-18.
  42. Zhang Y, Li Q, Xin Y, Lv W, Ge C. Association between serum magnesium and common complications of diabetes mellitus. Technol Health Care 2018;26:379-87.
  43. Broadhurst CL, Domenico P. Clinical studies on chromium picolinate supplementation in diabetes mellitus--a review. Diabetes Technol Ther 2006;8:677-87.
  44. Bo S, Pisu E. Role of dietary magnesium in cardiovascular disease prevention, insulin sensitivity and diabetes. Curr Opin Lipidol 2008;19:50-6.
  45. Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J 2012;5:i3-14.