de Valk H W, Verkaaik R, van Rijn H J, Geerdink R A, Struyvenberg A
Department of Internal Medicine, University Hospital, Utrecht, The Netherlands.
Diabet Med. 1998 Jun;15(6):503-7. doi: 10.1002/(SICI)1096-9136(199806)15:6<503::AID-DIA596>3.0.CO;2-M.
Oral magnesium (Mg) supplementation can improve insulin sensitivity and secretion in patients with Type 2 diabetes mellitus (DM). We studied the effect of Mg supplementation on glycaemic control, blood pressure, and plasma lipids in insulin-requiring patients with Type 2 DM. Fifty moderately controlled patients were randomized to 15 mmol Mg or placebo daily for 3 months. Plasma Mg, glucose, HbA1c, lipids, erythrocyte Mg, Mg and glucose concentrations in 24-h urine, and systolic and diastolic pressure were measured before and after 3 months treatment. Plasma Mg concentration was higher after supplementation than after placebo (0.82 +/- 0.07 vs 0.78 +/- 0.08 mmol l(-1), p < 0.05), as was Mg excretion (5.5 +/- 1.9 vs 3.7 +/- 1.4 mmol 24 h(-1), p = 0.004) but erythrocyte Mg concentrations were similar. No significant differences were found in glycaemic control (glucose: 10.7 +/- 3.8 vs 11.6 +/- 6.2 mmol l(-1), p = 0.8; HbA1c: 8.9 +/- 1.6 vs 9.1 +/- 1.2%, p = 0.8), lipids or blood pressure. On-treatment analysis (34 patients: 18 on Mg, 16 on placebo) yielded similar results. An increase in plasma Mg concentration irrespective of medication was associated with a tendency to a decrease in diastolic pressure (increased plasma Mg vs no increase: -4.0 +/- 10.1 vs +2.5 +/- 12.0 mmHg, p = 0.059). Three months' oral Mg supplementation of insulin-requiring patients with Type 2 DM increased plasma Mg concentration and urinary Mg excretion but had no effect on glycaemic control or plasma lipid concentrations.
口服补充镁(Mg)可改善2型糖尿病(DM)患者的胰岛素敏感性和分泌。我们研究了补充镁对需要胰岛素治疗的2型糖尿病患者血糖控制、血压和血脂的影响。50例病情得到适度控制的患者被随机分为两组,分别每日服用15 mmol镁或安慰剂,为期3个月。在治疗3个月前后,分别测量血浆镁、血糖、糖化血红蛋白(HbA1c)、血脂、红细胞镁、24小时尿镁和葡萄糖浓度以及收缩压和舒张压。补充镁后血浆镁浓度高于服用安慰剂后(0.82±0.07 vs 0.78±0.08 mmol l⁻¹,p<0.05),镁排泄量也是如此(5.5±1.9 vs 3.7±1.4 mmol 24 h⁻¹,p = 0.004),但红细胞镁浓度相似。在血糖控制(血糖:10.7±3.8 vs 11.6±6.2 mmol l⁻¹,p = 0.8;HbA1c:8.9±1.6 vs 9.1±1.2%,p = 0.8)、血脂或血压方面未发现显著差异。治疗期分析(34例患者:18例服用镁,16例服用安慰剂)得出了类似结果。无论用药情况如何,血浆镁浓度升高都与舒张压下降趋势相关(血浆镁升高与未升高:-4.0±10.1 vs +2.5±12.0 mmHg,p = 0.059)。对需要胰岛素治疗的2型糖尿病患者进行为期3个月的口服镁补充,可提高血浆镁浓度和尿镁排泄量,但对血糖控制或血脂浓度没有影响。