IJCM  Vol.9 No.2 , February 2018
Assessment of Serum Magnesium Level in Type 2 Diabetes Mellitus with Diabetic Foot Ulcers (Grade I and II) at Nawabshah, Pakistan
Abstract: Diabetes Mellitus is a metabolic disorder increasing morbidity and mortality worldwide, which needs exact identification and proper management. Aim of this study was to analyze the serum Mg (magnesium) level in patients with Type 2 Diabetes Mellitus with grade I & II diabetic foot ulcers. This descriptive cross sectional study was conducted at Medicine Department, PMCH Nawabshah from June 2015 to December 2016. A total of 110 Type 2 Diabetes Mellitus with foot ulcer patients, 51 with grade I and 59 with grade II out of total were included by purposive sampling. After consultation, subjects were categorized as gender, age, Type 2 DM and foot ulcer duration, foot ulcer grading and grouping for analyses. Wagner’s classification of diabetic foot ulcers used to analyze the data and blood samples were collected for research purpose in fasting state for serum Magnesium level analyses. Out of 110, 67 (65.5%) males and 43 (34.5%) females were reported with Type 2 diabetic patients. Hypomagnesaemia was reported in 59% patients out of total, 24 found with grade I and 38 found with grade II from the studied subjects. P value ≤ 0.000 was in the studied population in relation to hypomagnesaemia. In conclusion, Hypomagnesaemia is common in Type 2 Diabetes Mellitus patients with grade I & II foot ulcers. As the duration of Diabetes along with duration of diabetic foot ulcer in Grade I and II increases, the level of serum magnesium decreases. As the duration of Diabetes Mellitus increases, the severity of complications might also increase.
Cite this paper: Jamali, A. , Jamali, G. , Jamali, N. , Tanwani, B. , Rajput, A. and Jamali, A. (2018) Assessment of Serum Magnesium Level in Type 2 Diabetes Mellitus with Diabetic Foot Ulcers (Grade I and II) at Nawabshah, Pakistan. International Journal of Clinical Medicine, 9, 104-116. doi: 10.4236/ijcm.2018.92011.

[1]   Sean, F.D. (2006) What Is Diabetes: Diabetes Basic Facts Medicine International Number. Medicine, 34, 245-246.

[2]   Masharani, U. (2008) Diabetes Mellitus & Hypoglycemia. In: Tierney Jr., L.M., McPhee, S.J. and Papadakis, M.A., Eds., Current Medical Diagnosis & Treatment, McGraw-Hill Education, Columbus, 1142-1190.

[3]   Singh, N., et al. (2005) Preventing Foot Ulcers in Patients with Diabetes. JAMA, 293, 217-228.

[4]   Reiber, G.E., et al. (1999) Causal Pathways for Incident Lower-Extremity Ulcers in Patients with Diabetes from Two Settings. Diabetes Care, 22, 157-162.

[5]   Sarah, W., et al. (2004) Global Prevalence of Diabetes. Diabetes Care, 27, 1047-1053.

[6]   Shafique, M., et al. (2002) Beneficial Effects of Magnesium Supplementation in Diabetes Mellitus: An Animal Study. Pakistan Journal of Medical Research, 41, 73-76.

[7]   Pham, P.C., et al. (2007) Hypomagnesaemia in Patients with Type 2 Diabetes. Clinical Journal of the American Society of Nephrology, 2, 366-373.

[8]   Zafar, A. (2001) Management of Diabetic Foot-Two Years’ Experience. Journal of Ayub Medical College, 13, 14-16.

[9]   Griffiths, G.D. (2002) Diabetic Foot Disease. In: Cuschieri, S.A., Ed., Essential Surgical Practice, CRC Press, Boca Raton, 785-794.

[10]   Roariguez, M.M., et al. (2003) Oral Magnesium Supplementation Improves Insulin Sensitivity and Metabolic Control in Type 2 Diabetic Subjects. Diabetes Care, 26, 1147-1152.

[11]   Lee, M. (2013) Basic Skills in Interpreting Laboratory Data. 5th Edition, American Society of Health-System Pharmacists, Bethesda.

[12]   Lexi-Comp, Inc. (2015) Drug Information Handbook. A Comprehensive Resource for All Clinicians and Healthcare Professionals. 24th Edition, Lexi-Comp, Inc., Hudson.

[13]   Bringhurst, F.R., et al. (2012) Bone and Mineral Metabolism in Health and Disease. In: Longo, D.L., Ed., Harrison’s Principles of Internal Medicine, McGraw-Hill Global Education, Columbus.

[14]   Williamson, M.A., et al. (2011) Wallach’s Interpretation of Diagnostic Tests. 9th Edition, Wolters Kluwer/Lippincott Williams & Wilkins Health, Philadelphia.

[15]   Frier, B.M., et al. (2006) Diabetes Mellitus. In: Hunter, J.A., Ed., Principles and Practice of Medicine, Churchill Livingstone, Edinburgh, 805-847.

[16]   James, B.W. (2008) Classification of Foot Lesion in Diabetic Patients. In: John, B.H. and Micheal, P.A., Eds., Levin and O’Neal’s the Diabetic Foot, 7th Edition, Mosby Elsevier, Amsterdam, 221-226.

[17]   DeValk, H.W. (1999) Magnesium in Diabetes Mellitus. The Netherlands Journal of Medicine, 54, 139-146.

[18]   Rude, R.K. (1998) Magnesium Deficiency: A Cause of Heterogeneous Disease in Humans. Journal of Bone and Mineral Research, 13, 749-758.

[19]   Rude, R.K. (1992) Magnesium Deficiency and Diabetes Mellitus: Causes and Effects. Postgraduate Medicine, 92, 217-224.

[20]   Nadler, J.L., et al. (1995) Disorders of Magnesium Metabolism. Endocrinology Metabolism Clinics of North America, 24, 623-641.

[21]   Fujii, S., et al. (1982) Magnesium Levels in Plasma Erythrocyte and Urine in Patients with Diabetes Mellitus. Hormone and Metabolic Research, 14, 161-162.

[22]   WHO Study Group (1985) Diabetes Mellitus. Technical Report Series 727, World Health Organization, Geneva.

[23]   Mather, H.M., et al. (1979) Hypomagnesaemia in Diabetes. ClinChimActa, 95, 235-242.

[24]   McNair, P., et al. (1978) Hypomagnesemia: A Risk Factor in Diabetic Retinopathy. Diabetes, 27, 1075-1077.

[25]   McNair, P., et al. (1982) Renal Hypomagnesemia in Human Diabetes Mellitus: Its Relation to Glucose Homeostasis. European Journal of Clinical Investigation, 12, 81-85.

[26]   Djurhuus, M.S., et al. (2000) Hyperglycemia Enhances Renal Magnesium Excretion in Type 1 Diabetic Patients. Scandinavian Journal of Clinical and Laboratory Investigation, 60, 403-409.

[27]   Barbagallo, M., et al. (1993) Cellular Ionic Effects of Insulin in Normal Human Erythrocytes: A Nuclear Magnetic Resonance Study. Diabetologia, 36, 146-149.

[28]   Hwang, D.L., et al. (1993) Insulin Increases Intracellular Magnesium Transport in Human Platelets. The Journal of Clinical Endocrinology & Metabolism, 76, 549-553.

[29]   Berhane, S., et al. (2008) Hypomagnesemia in Ethiopians with Diabetes Mellitus. Ethnicity & Disease, 18, 147-151.

[30]   Ma, J., et al. (1995) Associations of Serum and Dietary Magnesium with cardiovascular Disease, Hypertension, Diabetes, Insulin, and Carotid Arterial Wall Thickness: The Atherosclerosis Risk in Communities Study. Journal of Clinical Epidemiology, 48, 927-940.

[31]   White, J.R., et al. (1998) Magnesium and Diabetes: A Review. The Annals of Pharmacotherapy, 27, 775-780.

[32]   Resnick, L.M., et al. (1988) Intracellular Free Magnesium in Hypertension: Relation to Peripheral Insulin Resistance. Journal of Hypertension, 6, 199-201.

[33]   Cristiane, H.S., et al. (2006) Magnesium and Diabetes Mellitus. Their Relation Clinical Nutrition, 25, 554-562.

[34]   RodríguezMorán, M., et al. (2001) Low Serum Magnesium Levels and Foot Ulcers in Subjects with Type 2 Diabetes. Archives of Medical Research, 32, 300-303.

[35]   Liao, F., et al. (1998) Is Low Magnesium Concentration a Risk Factor for Coronary Heart Disease: The Atherosclerosis Risk in Communities (ARIC) Study. American Heart Journal, 136, 480-490.

[36]   Pham, P.C., et al. (2005) Lower Serum Magnesium Levels Are Associated with More Rapid Decline of Renal Function in Patients with Diabetes Mellitus Type 2. Clinical Nephrology, 63, 429-436.

[37]   Sales, C.R. (2006) Magnesium and Diabetes Mellitus: Their Relation. Clinical Nutrition, 225, 554-562.

[38]   Ford, E.S., et al. (2003) Dietary Magnesium Intake in a National Sample of US Adults. The Journal of Nutrition, 133, 2879-2882.