A Study of Fasting Serum Magnesium Level in Type 2 Diabetes Mellitus and Correlation with its Complications

Pandichelvan, R (2012) A Study of Fasting Serum Magnesium Level in Type 2 Diabetes Mellitus and Correlation with its Complications. Masters thesis, Stanley Medical College, Chennai.


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INTRODUCTION: Diabetes mellitus, the metabolic disease characterized by hyperglycemia results from defects in insulin secretion, insulin action or both. The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction and failure of various organs like eyes, kidneys, nerves, heart and blood vessels. Majority of cases of diabetes fall into two broad categories, Type 1 and Type 2 Diabetes mellitus. Type 2 Diabetes accounts for approximately 90 to 95 percentage of all diagnosed cases of diabetes. Long term complications of diabetes are include retinopathy, nephropathy and peripheral neuropathy and foot ulcers. Patients with diabetes have an increased risk of atherosclerotic, cardiovascular diseases. Hypertension and abnormalities of lipid metabolism are often found in diabetes. There are several pathogenic processes involved in the development of either form of diabetes and long term complications .The basis of the abnormalities in carbohydrate, fat, protein metabolism in diabetes is deficient action of insulin on target tissues. Defective insulin action results from inadequate insulin secretion and or reduced tissue response to insulin action. Defect in insulin secretion or action on target organ frequently coexist in the same patient. Several vitamins and minerals act as cofactors in the enzyme reaction regulated by insulin. Deficiency of several vitamins and minerals such as vitamin E, potassium, magnesium, zinc and chromium may worse the carbohydrate intolerance. Of these the need for potassium or magnesium replacement is relatively easy to detect based on low serum levels. Magnesium is the fourth most abundant cation in the human body and the second most abundant intracellular cation. Magnesium plays an essential role in carbohydrate metabolism and in the insulin action. Magnesium acts as a cofactor in glucose transport mechanism of the cell membranes and various intra cellular enzymes involved in carbohydrate metabolism. The concentrations of serum magnesium in healthy people are remarkably constant where as 30 to 35% of diabetes have low serum magnesium concentration. Magnesium deficiency has a negative impact on glucose homeostasis and insulin sensitivity in patients with type 2 diabetes as well as the evaluation of the complications like retinopathy11 cardiovascular diseases, nephropathy and neuropathy. 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 hypomagnesemia in patients with type 2 diabetes and correlate serum magnesium concentrations with micro and macro vascular complications of diabetes. AIMS AND OBJECTIVES: 1. Estimating fasting serum magnesium concentration in patients with type 2 diabetes mellitus. 2. Correlating serum magnesium concentrations with micro and macro vascular complications of type 2 diabetes mellitus-retinopathy, nephropathy, neuropathy, hypertension and ischemic heart diseases. METHODOLOGY: Study Population: Patients with type 2 diabetes mellitus admitted in general medical ward in Government Stanley medical college hospital. Methods: 100 patients with type 2 DM who were admitted in general medical ward in Stanley Medical College Hospital were randomly selected for this study. From all patients detailed history, thorough clinical examination and relevant biochemical investigations were obtained. Inclusion Criteria: All case of type 2 DM admitted in Stanley medical hospital in general medical wards. Exclusion Criteria: • Chronic Diarrhea, • Malabsorption, • Patients with Renal Failure, • Patients on Diuretics, • Acute Myocardial Infarction in Last 6 Months, • Patient Having Alcohol Abuse, • Patients Receiving Mg Supplements or Mg containing Antacid. Statistical method: Statistical method analysis was done using chi square test and sample variable t test to compare proportions. Results were considered significant at p value <0.05. RESULTS: This study was composed of 100 patients of type 2 DM of which 54 were men and 46 were women. These patients were further grouped according to their age, duration of diabetes, mode of treatment, glycemic control, presence or absence of co morbidities (ischemic heart disease and hypertension) and presence /absence of diabetic complications (retinopathy, neuropathy and nephropathy). SUMMARY: In our study done in hundred patients admitted in general medical ward in Stanley Medical College Hospital following conclusions were obtained. Summarizing our study : • 42 patients had hypomagnesemia (42 %). • Youngest patient in our study was 45 years of age ; mean age of patients in our study was 57.73 years. • All patients who were > 70 years were hypomagnesemic • As the age increased prevalence of hypomagnesemia increased ; this concurred with studies done before. • As the duration of diabetes increased the prevalence of hypomagnesemia increased ; this was similar to the study result of Sharma et al ; • Those who had a higher FBS and HbA1c% had higher prevalence of hypomagnesemia. This concurred with studies done before. • Hypomagnesemic patients had a higher incidence of complications like neuropathy, retinopathy, and nephropathy. • Hypomagnesemia correlated with higher incidence of ischemic heart disease and hypertensive heart disease. CONCLUSION: Low serum magnesium levels are commonly seen in diabetic patients. Hypomagnesemia is more common in diabetic patients with poor glycemic control. Hypomagnesemia in diabetic patients correlates well with duration of illness, glycemic control and complications of diabetes mellitus - both macro vascular and micro vascular.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Fasting Serum Magnesium Level ; Type 2 Diabetes Mellitus ; Correlation ; Complications.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 25 Mar 2018 06:01
Last Modified: 27 Mar 2018 15:04
URI: http://repository-tnmgrmu.ac.in/id/eprint/6565

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