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Magnesium and Type 2 Diabetes
Magnesium is an essential nutrient and a common ingredient of dietary supplements meant to reduce blood sugar. Studies have shown that magnesium can improve insulin action and reduce insulin resistance but can magnesium supplementation improve glycemic control? Read to find out how magnesium affects blood glucose level and diabetes complications.
by Brad Chase
Magnesium is an essential mineral in all living things. It is found in all human cells where it is required to bind to and activate adenosine triphosphate (ATP), the chief energy molecule of cells. While all cells need magnesium, its concentration differs from one cell type to another.
Magnesium is also a cofactor for over 300 enzymes involved with the production and utilization of ATP, DNA and RNA.
The recommended daily intake requirement of magnesium for adults is 300 – 400 mg/day.
Even though almost all food plants contain magnesium, it is present in low concentrations. However, there are still excellent plant sources of the mineral. Important dietary sources of magnesium include green vegetables, seeds, nuts, whole grains, dark chocolate and bran. It can also be found in halibut, milk, oats, and peanut butter.
Refined, processed foods usually do not contain appreciable amounts of magnesium because the mineral readily dissolves in water and is lost during food processing.
The high solubility of magnesium in water also means that it is easily excreted from the body with urine. Therefore, magnesium deficiency is commonly among diabetics.
Quite a number of magnesium salts are used in medicine. These include inorganic magnesium preparations as well as organic salts.
The main indication for magnesium supplement is to reverse magnesium deficiency and hypomagnesemia. However, some magnesium salts do have other specific purposes. For example, hydrate magnesium sulfate or Epsom salt is used as a laxative in high doses but it can also be used to relieve heartburn, constipation, eclampsia, hypertension and seizures.
Magnesium oxide and milk of magnesia (magnesium hydroxide) are poorly absorbed in the gastrointestinal tract. Therefore, their main indication is as antacids to help neutralize stomach acid.
Magnesium deficiency resulting from inadequate intake of the mineral can cause anxiety, migraines, muscles spasms, high blood pressure, cardiovascular problems, osteoporosis and diabetes.
Because magnesium is readily soluble, magnesium toxicity or hypermagnesemia only affect those with kidney problems. However, excess oral intake of magnesium may cause diarrhea as the body tries to eliminate the excess magnesium before it is absorbed.
Studies have shown that low serum magnesium levels are strongly associated with type 2 diabetes, hypertension and metabolic syndrome. Therefore, magnesium supplementation provides clear benefits for those suffering from these disorders.
In addition, magnesium supplements have been shown to be especially effective for those suffering from treatment-resistant diabetes.
Lastly, magnesium prevents the calcification of the blood vessels. This is an especially useful outcome for patients suffering from kidney problems and cardiovascular diseases. Magnesium can prevent fatty deposits from accumulating in the walls of major blood vessels.
Epidemiological studies have also confirmed that low intake of dietary and/or supplemental sources of magnesium can increase the risk of stroke, hypertension and other manifestation of atherosclerosis.
There is a consensus among medical researchers that magnesium supplementation is useful in the treatment of type 2 diabetes.
While studies are underway to determine whether increasing magnesium levels in the body directly translates to better blood sugar control, it has been confirmed that magnesium can improve insulin sensitivity and reduce the risks of cardiovascular diseases associated with diabetes.
In addition, magnesium deficiency is more common among people with diabetes (both type 1 and type 2) than non-diabetics.
In fact, expert believe magnesium deficiency is a risk factor for diabetes. For example, the incidence of hypomagnesemia among African Americans is higher (20%) than for the rest of the population. Experts believe that low magnesium level may be one the reasons African Americans also have increased risks of diabetes, hyperlipidemia and hypertension.
This observation is further strengthened by the clinical data that found a strong correlation between insulin resistance and low magnesium levels even among non-diabetic elderly African Americans.
A number of studies have established that both the plasma level of magnesium and the level of free magnesium inside cells (intracellular) are lower in diabetics than the general population. However, the intracellular magnesium level in red blood cells is a more accurate measure of insulin resistance and diabetes than plasma magnesium level.
Besides increasing the utilization of excess glucose, insulin also drives magnesium into cells along with glucose. This means that insulin increases intracellular magnesium levels while reducing plasma magnesium levels.
Therefore, when the body develops insulin resistance during type 2 diabetes, magnesium is no longer actively pushed into cells. This causes intracellular magnesium levels to fall.
By administering more magnesium, it is possible to increase intracellular magnesium levels and reduce insulin resistance. One group of researchers achieved this by overcoming insulin resistance in skeletal muscles by increasing the intracellular concentration of magnesium in the cells of the muscle.
In fact, most of the drugs used in the treatment of diabetes increase magnesium levels. For example, metformin raises magnesium levels in the liver and pioglitazone was proven to increase magnesium levels in fat cells.
This means that increasing magnesium levels is one of the major means by which anti-diabetic drugs reduce insulin resistance.
A 1999 paper published in the Archives of Internal Medicine took some of the data from The Atherosclerosis Risk in Communities Study to investigate the link between serum and dietary magnesium and the risk of type 2 diabetes.
This study involved over 12,000 non-diabetic, middle-aged adults whose diets were monitored over a period of 6 years.
The study concluded that although low dietary magnesium intake was not linked to type 2 diabetes, low serum magnesium level was a strong predictor of this type of diabetes.
However, some other studies have found that dietary magnesium intake can affect the risk of type 2 diabetes. One of such studies was published in the journal, Diabetes Care, in 2004. In that study, the researchers investigated the association between magnesium intake and the risk of type 2 diabetes.
In this large and long-term study, the magnesium intake of over 120,000 men and women was monitored with food frequency questionnaires. At the beginning of this study, none of the participants had diabetes, cancer or cardiovascular diseases.
These participants were monitored for 12 – 18 years and asked to fill the questionnaires every 2 – 4 years.
After adjusting for body weight, physical activity, diet and family history of diabetes, the study results showed that magnesium intake can reduce the risk of diabetes. The researchers concluded that by increasing dietary (and supplementary) magnesium, the risk of type 2 diabetes can be significantly reduced.
In a second related study published in the same journal in the same year, another group of researchers investigated the link between dietary magnesium intake, plasma insulin levels and the risks of type 2 diabetes.
By gathering data from the Women’s Health Study involving almost 40,000 women over the age of 45 and with no previous history of cancer, cardiovascular disease or type 2 diabetes, the authors of this study were able to determine the effect of dietary magnesium intake on the incidence of type 2 diabetes.
From the data collected over 6 years, the researchers concluded that a higher intake of magnesium can significantly reduce the risk of type 2 diabetes in overweight women.
A 2007 paper published in the journal, JAMA Internal Medicine, investigated the effect of dietary fiber and magnesium on the risk of type 2 diabetes.
This paper described a prospective study involving over 24,000 adults aged between 35 and 65 years as well as a meta-analysis of 17 other studies done investigating the effects of fiber or magnesium in the progression of diabetes.
The result of this aggregating study concluded that higher cereal fiber and magnesium intakes can reduce the risk of diabetes.
A 1997 paper published in the American Journal of Diabetes investigated the role of intracellular magnesium in the incidence and progression of hypertension, insulin resistance and type 2 diabetes.
The authors of this paper noted that in vivo and in vitro studies have confirmed that insulin can help move more magnesium into cells and that intracellular magnesium can, in turn, enhance insulin actions (especially the utilization of glucose).
They also noted that low intracellular magnesium levels are commonly reported in type 2 diabetes and hypertensive patients. This is also closely associated with increased intracellular levels of calcium and defects in tyrosine-kinase portion of insulin receptors.
The increased calcium levels and defective insulin receptors are believed to be responsible for the increased insulin resistance in type 2 diabetes patients.
Therefore, magnesium supplementation can increase intracellular magnesium levels, reduce insulin resistance, increase glucose uptake by cells and reduce blood pressure in the arteries.
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