Optimal serum magnesium levels improve glycemic control post bariatric surgery in diabetes patients

A new study published in BMC Endocrine Disorders suggests that greater serum magnesium (MG) levels at baseline and 1 year after bariatric surgery (BS) were linked to improved glycemic control and higher rates of complete type 2 diabetes mellitus (T2DM) remission in patients with T2DM.

Type 2 diabetes mellitus risk has been linked to low magnesium dietary consumption. Hypomagnesemia is also linked to the lowest glycemic control in T2DM patients. The most effective therapy for extreme obesity is still bariatric surgery, which also helps with or improves T2DM. Silva MM and colleagues also conducted an observational research on individuals with obesity and T2DM who had BS with the primary objective of evaluating the relationship between Mg supplementation post-BS and Mg serum levels with diabetes status after BS. Data were evaluated prior to the BS and one year thereafter.

The key findings of this study were:

A total of 403 T2DM individuals were enrolled in the study. 

43.4% of the patients exhibited a magnesium deficit at the outset. Pre-BS, patients with Mg shortage had worse glycemic control, with HbA1c of 7.2 ± 1.6% compared to 6.4 ± 1.0% (p 0.001), fasting plasma glucose of 146.2 ± 58.8 mg/dL compared to 117.5 ± 36.6 mg/dL (p 0.001), and use of more anti-diabetic medications, 1.0 (IQR 0-2.0) 

These results remained true a year after the BS. 58.4% of patients experienced complete remission of T2DM at one year after BS, whereas 4.1% received partial remission. 

At one year post-BS, patients without Mg shortage exhibited greater whole and partial remission rates. 

The overall T2DM remission is independently predicted by higher baseline serum Mg levels.

With a sensibility of 73% and a specificity of 58% (area under the ROC = 0.65), 1.50 mg/dL was chosen as the ideal baseline Mg cut-off to predict overall T2DM remission. 

Following BS, individuals receiving Mg supplements had blood Mg levels, glycemic control, and complete remission of T2DM equivalent to patients not receiving supplements.

In conclusion, the best baseline Mg cut-off for predicting overall T2DM resolution was 1.50 mg/dL.

Reference: 

MM, S., JS, N., M, B.-C., AP, M., MJ, F., F, M., MJ, F., D, S., J, P., V, G., E, L., A, V., P, F., & D, C. (2022). Higher magnesium levels are associated with better glycaemic control and diabetes remission post-bariatric surgery. In BMC Endocrine Disorders (Vol. 22, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12902-022-01210-4