Published online Aug 25, 2015. doi: 10.4239/wjd.v6.i10.1152
Peer-review started: April 18, 2015
First decision: May 13, 2015
Revised: June 29, 2015
Accepted: August 16, 2015
Article in press: August 17, 2015
Published online: August 25, 2015
Type 2 diabetes is frequently associated with both extracellular and intracellular magnesium (Mg) deficits. A chronic latent Mg deficit or an overt clinical hypomagnesemia is common in patients with type 2 diabetes, especially in those with poorly controlled glycemic profiles. Insulin and glucose are important regulators of Mg metabolism. Intracellular Mg plays a key role in regulating insulin action, insulin-mediated-glucose-uptake and vascular tone. Reduced intracellular Mg concentrations result in a defective tyrosine-kinase activity, postreceptorial impairment in insulin action and worsening of insulin resistance in diabetic patients. A low Mg intake and an increased Mg urinary loss appear the most important mechanisms that may favor Mg depletion in patients with type 2 diabetes. Low dietary Mg intake has been related to the development of type 2 diabetes and metabolic syndrome. Benefits of Mg supplementation on metabolic profiles in diabetic patients have been found in most, but not all clinical studies and larger prospective studies are needed to support the potential role of dietary Mg supplementation as a possible public health strategy in diabetes risk. The aim of this review is to revise current evidence on the mechanisms of Mg deficiency in diabetes and on the possible role of Mg supplementation in the prevention and management of the disease.
Core tip: Diabetes is frequently associated with Mg deficit. The fact that most but not all diabetic subjects have low magnesium (Mg) and that no large randomised controlled trial (RCT) has been specifically focused on subjects with Mg deficit, diagnosed with a reliable technique, may help explain discrepancies of the role of supplemental Mg on glycemic control, and the impact on diabetes risk in prospective epidemiological studies. Different baseline Mg, metabolic control, and age are other potential factors that may contribute. Future prospective RCTs are needed to support the potential role of dietary Mg supplementation as a possible public health strategy to reduce diabetes risk in the population.