Karthikeyan, K (2012) Serum Magnesium and End Organ Damage in Type 2 Diabetes Mellitus. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Diabetes Mellitus (DM), characterized by metabolic disorders related to high levels of serum glucose, is probably the most associated disease to Mg depletion in intra and extra cellular compartments. Hypomagnesemia has been related as a cause of insulin resistance, also being a consequence of hyperglycemia, and when it is chronic leads to the installation of macro and microvascular complications of diabetes, worsening the deficiency of Mg. The mechanism involving the DM and hypomagnesemia was still unclear, although some metabolic studies demonstrate that Mg supplementation has a beneficial effect in the action of insulin and in the glucose metabolism. Hypomagnesemia has long been known to be associated with diabetes mellitus. Low serum magnesium level has been reported in children with insulin dependent diabetes mellitus and through the entire spectrum of adult type 1 and type 2 diabetes mellitus regardless of the type of therapy. Initially the cause of hypomagnesaemia was attributed to osmotic renal losses from glycosuria decreased intestinal magnesium absorption and redistribution of magnesium from plasma into red blood cells caused by insulin effect. Recently a specific tubular magnesium defect in diabetes has been postulated. Hypermagnesuria results specifically from a reduction in tubular absorption of magnesium. Magnesium is involved on multiple levels in insulin secretion, binding and activity. Cellular magnesium deficiency can alter of the membrane bound sodium-potassium-adenosine triphospatase which is involved in the maintenance of gradients of sodium and potassium and in glucose transport. The concentrations of magnesium in serum of healthy people are remarkably constant, whereas 25-39% of diabetics have low concentrations of serum magnesium. Magnesium depletion has a negative impact on glucose homeostasis and insulin sensitivity in patients with type 2 diabetes, as well as on the evolution of complications such as retinopathy, arterial atherosclerosis and nephropathy. Moreover, low serum magnesium is a strong, independent predictor of development of type 2 diabetes. The present study was undertaken with an aim to estimate prevalence of hypomagnesaemia in patients with type 2 DM and to correlate the serum magnesium concentrations with micro and macrovascular complications of diabetes – retinopathy, nephropathy, neuropathy and ischemic heart disease. AIM OF THE STUDY: 1. Estimating fasting serum magnesium concentrations in patients with type 2 diabetes mellitus. 2. Correlating serum magnesium concentrations with micro and macrovascular complications of type 2 diabetes mellitus - retinopathy, nephropathy, neuropathy and ischemic heart disease. MATERIALS AND METHODS: This study was undertaken with the aim to determine serum magnesium level in patients with Type 2 Diabetes Mellitus without it's associated complications and Type 2 Diabetes mellitus patients with its various macro and microvascular complications namely Coronary atherosclerosis, Hypertension, retinopathy, neuropathy and nephropathy respectively. Study Population: The study was conducted at Government Rajaji Hospital, Madurai on total of 120 subjects of age group 40 - 70 years; of whom 20 were apparently healthy and served as control. Inclusion criteria: All cases of type 2 diabetes mellitus coming to Dept. of Diabetology, GRH, Madurai. During the period of April 2011 to October 2011. Exclusion criteria: 1. Patients with chronic renal failure. 2. Acute myocardial infarction in last 6 months. 3. Patients on diuretics. 4. Patients with history of alcohol abuse. 5. Patients receiving magnesium supplements or magnesium containing antacids. 6. Malabsorption or chronic diarrhea. CONCLUSION: 1. Prevalence of hypomagnesemia in type 2 diabetes is 39%. 2. Hypomagnesemia has significant association with glycemic control which was reflected in uncontrolled fasting blood sugar (FBS >130 mg%) and Hb A1C >7 (p value 0.0068) & (p value0.0013 ) respectively. 3. Hypomagnesemia have no significant relation with age, sex and treatment mode of the diabetic patients but it has significant association with duration of diabetes. 4. Hypomagnesemia is significantly associated with diabetic retinopathy (p value 0.0001). 5. No significant association between other diabetic microangiopathies (nephropathy and neuropathy) and diabetic comorbidities – ischemic heart disease and hypertension.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Serum Magnesium ; End Organ Damage ; Type 2 Diabetes Mellitus. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 20 Mar 2018 02:01 |
| Last Modified: | 20 Mar 2018 02:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/6369 |
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