Magnesium and disturbances in carbohydrate metabolism.
Diabetes Obes Metab. 2015 May 13. Epub 2015 May 13. PMID: 25974209
Frank C Mooren
Magnesium (Mg) is actively involved in a number of metabolic reactions as an important co-factor with special emphasis on carbohydrate metabolism. After a brief overview of the regulation of intra- and extracellular Mg, the current review first describes the regulatory role of Mg in important metabolic pathways involved in energy metabolism and glycaemic control. The review then characterizes the clinical significance of hypomagnesaemic conditions for alterations in glucose handling in prediabetic stages such as insulin resistance/impaired glucose tolerance and in type 2 diabetes mellitus. Cross-sectional as well as longitudinal studies suggest that a reduced dietary Mg intake serves as a risk factor for the incidence of both impaired glucose regulation and type 2 diabetes. Mechanisms which might be responsible for diabetes-associated hypomagnesaemia are discussed. Furthermore, the role of hypomagnesaemia in the development and progression of chronic diabetic complications will be addressed. Finally, the available literature about the effects of Mg supplementation on parameters of glycaemic control during prediabetic conditions (preventive approach) as well as type 2 diabetes mellitus (therapeutic approach) will be reviewed systematically. There is considerable evidence that chronic Mg supplementation may delay the progression from impaired glucose regulation to type 2 diabetes. In contrast, the effects of oral Mg supplementation as an adjunct therapy for type 2 diabetes are quite heterogeneous with respect to the various parameters of glycaemic control. These results require critical consideration of the pros and cons of a Mg replacement therapy depending on parameters such as Mg status, stage of disease and glycaemic control.