China: A recent study in the journal Nutrients showed that a lower concentration of serum magnesium is associated with a higher risk of insulin resistance (IR) and type 2 diabetes (T2D).
Globally, the increasing burden of type 2 diabetes has led to high morbidity and socioeconomic impact in developing countries. In India, too, it has become a silent epidemic and is estimated that over 60 million people are affected by diabetes. In recent years, although, a lot of research has been done on diabetes management, the latest treatment modalities may not be affordable at all. Considering this, it becomes important to prioritize research on prevention and primary care.

Magnesium is an essential mineral for the human body and a cofactor or activator for more than 300 enzymatic reactions, including insulin release and blood glucose control. Hypomagnesia has been demonstrated to precipitate hyperglycemia and therefore has been implicated in insulin resistance and its microvascular complications. Poor blood sugar control has been associated with retinopathy. Hence, Weiyi Li, Chinese Center for Disease Control and Prevention, Beijing, China, and colleagues evaluated the association of serum magnesium with type 2 diabetes mellitus and diabetic retinopathy in a prospective cohort study.
The study included 5044 participants aged 18 years and older without insulin resistance (IR) and diabetes at the baseline from China Health and Nutrition Survey (CHNS). For measuring both types of magnesium, hemoglobin A1c (HbA1c), fasting blood glucose, and fasting insulin, a fasting blood sample was taken.
The researchers recorded demographic characteristics of participants, and risk factors such as intensity of physical activities, smoking status, drinking habits, and anthropometric information. IR was defined as HOMA-IR ≥ 2.5, and Type 2 diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/L or HbA1c ≥ 6.5%, or a self-reported diagnosis or treatment of diabetes.
During an average follow-up of 5.8 years, a total of 1331 incident insulin resistance events and 429 incident diabetic events were recorded.
Based on the study, the researchers reported the following:
The serum magnesium concentration was categorized into quintiles.
After adjusting for relevant covariates, the third quintile of serum magnesium (0.89–0.93 mmol/L) was correlated with a 29% lower risk of incident insulin resistance (hazard ratio = 0.71) and with a lower risk of Type 2 diabetes.
Multivariable-adjusted hazard ratios for insulin resistance were compared with the lowest quintile of serum magnesium (<0.85).
The researchers found similar results when evaluating serum magnesium as a continuous measure.
Restricted cubic spline (RCS) curves showed a nonlinear dose-response correlation in both serum magnesium levels and insulin resistance and in serum magnesium levels and Type 2 diabetes.
"Lower serum magnesium is associated with IR and type 2 diabetes in patients with normal serum magnesium levels," wrote the authors. "Nonlinear dose–response relationships were found in both serum magnesium and IR, and in serum magnesium and Type 2 diabetes."
"Further discussion is warranted for the potential reasons for the U-shaped association between serum magnesium levels, and the risk of IR and diabetes," they concluded.
Reference:
Li W, Jiao Y, Wang L, Wang S, Hao L, Wang Z, Wang H, Zhang B, Ding G, Jiang H. Association of Serum Magnesium with Insulin Resistance and Type 2 Diabetes among Adults in China. Nutrients. 2022 Apr 25;14(9):1799. doi: 10.3390/nu14091799. PMID: 35565766; PMCID: PMC9104014.