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Sunday, 15 December 2013

Magnesium and Types 2 Diabetes

Magnesium
Magnesium is the eleventh most abundant element by mass in the human body. The adult body content is 25 g distributed in the skeleton and soft tissues. The chemical is essential in manipulating important biological polyphosphate such as ATP, DNA, and RNA and in functionming enzymes(a).
Magnesium and Type II diabetes
1. High dietary magnesium intake is associated with low insulin resistance in the Newfoundland population
In the study to investigate the association between magnesium intake and IR in normal-weight (NW), overweight (OW) and obese (OB) along with pre- and post- menopausal women, showed that subjects with the highest intakes of dietary magnesium had the lowest levels of circulating insulin, HOMA-IR, and HOMA-ß and subjects with the lowest intake of dietary magnesium had the highest levels of these measures, suggesting a dose effect. Multiple regression analysis revealed a strong inverse association between dietary magnesium with IR. In addition, adiposity and menopausal status were found to be critical factors revealing that the association between dietary magnesium and IR was stronger in OW and OB along with Pre-menopausal women(1).

2. Magnesium intake and risk of type 2 diabetes
In the study to assess the association between magnesium intake and risk of type 2 diabetes with retrieved studies published in any language by systematically searching MEDLINE from 1966 to February 2007 and by manually examining the references of the original articles, found that magnesium intake was inversely associated with incidence of type 2 diabetes. This finding suggests that increased consumption of magnesium-rich foods such as whole grains, beans, nuts, and green leafy vegetables may reduce the risk of type 2 diabetes(2).

3. Fiber and magnesium intake and incidence of type 2 diabetes
In the study to examine associations between fiber and magnesium intake and risk of type 2 diabetes and summarized existing prospective studies by meta-analysis, found that during 176 117 person-years of follow-up, we observed 844 incident cases of type 2 diabetes in the European Prospective Investigation Into Cancer and Nutrition-Potsdam. Higher cereal fiber intake was inversely associated with diabetes risk (RR for extreme quintiles, 0.72 [95% confidence interval [CI], 0.56-0.93]), while fruit fiber (0.89 [95% CI, 0.70-1.13]) and vegetable fiber (0.93 [95% CI, 0.74-1.17]) were not significantly associated. Meta-analyses showed a reduced diabetes risk with higher cereal fiber intake (RR for extreme categories, 0.67 [95% CI, 0.62-0.72]), but no significant associations for fruit (0.96 [95% CI, 0.88-1.04]) and vegetable fiber (1.04 [95% CI, 0.94-1.15]). Magnesium intake was not related to diabetes risk in the European Prospective Investigation Into Cancer and Nutrition-Potsdam (RR for extreme quintiles, 0.99 [95% CI, 0.78-1.26]); however, meta-analysis showed a significant inverse association (RR for extreme categories, 0.77 [95% CI, 0.72-0.84])(3).

4. Dietary calcium and magnesium, major food sources, and risk of type 2 diabetes in U.S. black women
In a a prospective cohort study including 41,186 participants of the Black Women's Health Study without a history of diabetes who completed validated food frequency questionnaires at baseline, during 8 years of follow-up (1995-2003), we documented 1,964 newly diagnosed cases of type 2 diabetes, showed that
a diet high in magnesium-rich foods, particularly whole grains, is associated with a substantially lower risk of type 2 diabetes in U.S. black women(4).

5. Serum and dietary magnesium and the risk for type 2 diabetes mellitus
In the study to assess the risk for type 2 diabetes associated with low serum magnesium level and low dietary magnesium intake in a cohort of nondiabetic middle-aged adults (N = 12,128) from the Atherosclerosis Risk in Communities Study during 6 years of follow-up, found that aassessed the risk for type 2 diabetes associated with low serum magnesium level and low dietary magnesium intake in a cohort of nondiabetic middle-aged adults (N = 12,128) from the Atherosclerosis Risk in Communities Study during 6 years of follow-up(5).

6.  Associations of serum and urinary magnesium with the pre-diabetes, diabetes and diabetic complications in the Chinese Northeast population
In the study to investigate the association of Mg level in the serum or urine of the patients, lived in the Northeast areas of China, with either pre-diabetes or diabetes with and without complications, from January 2010 to October 2011, patients with type 1 diabetes (T1D, n = 25), type 2 diabetes (T2D, n = 137), impaired fasting glucose (IFG, n = 12) or impaired glucose tolerance (IGT, n = 15), and age/gender matched control (n = 50) enrolled in the First Hospital of Jilin University, showed that serum Mg levels in the patients with IGT, IFG, T2D, and T1D were significantly lower than that of control. The urinary Mg levels were significantly increased only in T2D and T1D patients compared to control. There was no difference for these two changes among T2D with and without complications; In addition, there was a significantly positive correlation of serum Mg levels with serum Ca levels only in T2D patients, and also a significantly positive correlation of urinary Mg levels with urinary Ca levels in control, IGT patients, and T2D patients. Simvastatin treatment in T2D patients selectively reduced serum Ca levels and urinary Mg levels(6).

7. Efficacy and safety of oral magnesium supplementation in the treatment of depression in the elderly with type 2 diabetes
In the study to evaluate the efficacy and safety of oral magnesium supplementation, with magnesium chloride (MgCl2), in the treatment of newly diagnosed depression in the elderly with type 2 diabetes and hypomagnesemia, found that at baseline, there were no differences by age (69 +/- 5.9 and 66.4 +/- 6.1 years, p = 0.39), duration of diabetes (11.8 +/- 7.9 and 8.6 +/- 5.7 years, p = 0.33), serum magnesium levels (1.3 +/- 0.04 and 1.4 +/- 0.04 mg/dL, p = 0.09), and Yasavage and Brink Score (17.9 +/- 3.9 and 16.1 +/- 4.5 point, p = 0.34) in the groups with MgCl2 and imipramine, respectively. At end of follow-up, there were no significant differences in the Yasavage and Brink score (11.4 +/- 3.8 and 10.9 +/- 4.3, p = 0.27) between the groups in study; whereas serum magnesium levels were significantly higher in the group with MgCl2 (2.1 +/- 0.08 mg/dL) than in the subjects with imipramine (1.5 +/- 0.07 mg/dL), p < 0.0005. In conclusion, MgCl2 is as effective in the treatment of depressed elderly type 2 diabetics with hypomagnesemia as imipramine 50 mg daily(7).

8. The effect of magnesium supplementation on primary insomnia in elderly
In a double-blind randomized clinical trial conducted in 46 elderly subjects, randomly allocated into the magnesium or the placebo group and received 500 mg magnesium or placebo daily for 8 weeks with Questionnaires of insomnia severity index (ISI), physical activity, and sleep log completed at baseline and after the intervention period, showed that no significant differences were observed in assessed variables between the two groups at the baseline. As compared to the placebo group, in the experimental group, dietary magnesium supplementation brought about statistically significant increases in sleep time (P = 0.002), sleep efficiency (P = 0.03), concentration of serum renin (P < 0.001), and melatonin (P = 0.007), and also resulted in significant decrease of ISI score (P = 0.006), sleep onset latency (P = 0.02) and serum cortisol concentration (P = 0.008). Supplementation also resulted in marginally between-group significant reduction in early morning awakening (P = 0.08) and serum magnesium concentration (P = 0.06). Although total sleep time (P = 0.37) did not show any significant between-group differences(8).

9. Correlation of magnesium intake with metabolic parameters, depression and physical activity in elderly type 2 diabetes patients
In a cross-sectional study involved 210 type 2 diabetes patients aged 65 years and above with participants were interviewed to obtain information on lifestyle and 24-hour dietary recall. Assessment of depression was based on DSM-IV criteria, showed that among all patients, 88.6% had magnesium intake which was less than the dietary reference intake, and 37.1% had hypomagnesaemia. Metabolic syndromes and depression were associated with lower magnesium intake (p < 0.05). A positive relationship was found between magnesium intake and HDL-cholesterol (p = 0.005). Magnesium intake was inversely correlated with triglyceride, waist circumference, body fat percent and body mass index (p < 0.005). After controlling confounding factor, HDL-cholesterol was significantly higher with increasing quartile of magnesium intake (p for trend = 0005). Waist circumference, body fat percentage, and body mass index were significantly lower with increase quartile of magnesium intake (p for trend < 0.001). The odds of depression, central obesity, high body fat percentage, and high body mass index were significantly lower with increasing quartile of magnesium intake (p for trend < 0.05). In addition, magnesium intake was related to high physical activity level and demonstrated lower serum magnesium levels. Serum magnesium was not significantly associated with metabolic parameters(9).

10. Depressive symptoms and hypomagnesemia in older diabetic subjects
In the study to to assess the hypothesis that hypomagnesemia is associated with depressive symptoms in older people with diabetes, showed that serum magnesium levels were significantly lower among depressive than control diabetic subjects (0.74 +/- 0.25 vs. 0.86 +/- 0.29 mmol/L, p = 0.02). Twenty four (43.6%) and 7 (12.7%) individuals in the case and control group exhibited low serum magnesium levels (p = 0.0006). The adjusted logistic regression analysis showed an independent association between hypomagnesemia and depressive symptoms (OR 1.79; CI(95%) 1.1-6.9, p = 0.03)(10).

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/23472169
(2) http://www.ncbi.nlm.nih.gov/pubmed/17645588
(3) http://www.ncbi.nlm.nih.gov/pubmed/17502538
(4) http://www.ncbi.nlm.nih.gov/pubmed/17003299
(5) http://www.ncbi.nlm.nih.gov/pubmed/10527292
(6) http://www.ncbi.nlm.nih.gov/pubmed/23418599
(7) http://www.ncbi.nlm.nih.gov/pubmed/19271419
(8) http://www.ncbi.nlm.nih.gov/pubmed/23853635
(9) http://www.ncbi.nlm.nih.gov/pubmed/22695027
(10) http://www.ncbi.nlm.nih.gov/pubmed/17845894