HYPOMAGNESEMIA AS AN IMPORTANT ELECTROLYTE IMBALANCE IN PATIENTS WITH DIABETIC NEPHROPATHY

Abstract

Background & Objective: Diabetes Miletus (T2DM) leads to disturbances in the homeostasis of different inorganic minerals, including Magnesium, particularly in diabetic nephropathy (DN) patients. The study aimed to find the frequency of hypomagnesemia in patients with T2DM with early DN. It also compares glycemic control (HbA1c levels) and renal function between patients with and without hypomagnesemia.

Methodology: This cross-sectional study was conducted in internal medicine department, Hameed Latif Hospital, Lahore during June 2025 and September 2024. Non-probability consecutive sampling was used. The T2DM patients aged 20-65 years with venous fasting blood sugar (FBS) ≥ 6.5 mmol/L with early DN were included. Thus, comparison of groups (hypomagnesaemia as yes/no) was done with age, BMI, duration of diabetes, HbA1c, eGFR, UACR, and serum magnesium levels using non-parametric Mann-Whitney U test. The multivariate logistic regression model was performed with dependent binary variable (hypomagnesemia) taking p < 0.05 to confirm statistical significance at 95% CI.

Results: The 15 (10%) T2DM patients reported hypomagnesemia, with mean age of 49.07 ± 6.46 years, including 7 males and 8 females. In bivariate analysis, hypomagnesemia is significantly associated to middle adult age, duration of DM, glycemic control (HbA1c levels), UACR levels and renal function (eGFR) (p < 0.05). While doing logistic regression (multivariate) analysis, only age was significant with odds ratio of (OR = 0.91, 95% CI: 0.83–0.98, p = 0.02).

Conclusion: The study highlights the importance of monitoring hypomagnesemia among T2DM patients, both with or without early DN. Hypomagnesemia is found to be prevalent in T2DM and associated with glycemic control (HbA1c), renal function (eGFR), and UACR levels. However, no association was found between BMI, gender, and retinopathy. Interestingly, magnesium imbalance was observed even among patients with relatively preserved renal function and normal to mildly increased UACR levels, suggesting that hypomagnesemia may occur during the early stages of DN. No significant association was found between hypomagnesemia and BMI, gender, or retinopathy. In multivariate analysis, only age is significantly associated to hypomagnesemia among T2DM patients with or without early DN.