Skip to main content
SpringerLink
Log in

Magnesium Status and Dietary Patterns Associated with Glycemic Control in Individuals with Type 2 Diabetes Mellitus

  • Published:
Biological Trace Element Research Aims and scope Submit manuscript

Abstract

Hypomagnesemia and unhealthy eating patterns are associated with poor glycemic control in individuals with type 2 diabetes mellitus (T2DM). This study aimed to associate magnesium status and dietary patterns with glycemic control in T2DM individuals. This cross-sectional study included 147 individuals with T2DM, aged between 19 and 59 years, of both sexes, residents in Sergipe/Brazil. The BMI, waist circumference, %body fat, plasma magnesium, serum glucose, insulin, %HbA1c, triacylglycerol, total cholesterol, LDL-c, and HDL-c were analyzed. Eating patterns were identified using a 24-h recall method. Logistic regression models were used to verify the association of magnesium status and dietary patterns with markers of glycemic control by adjusting for sex, age, time of T2DM diagnosis, and BMI. A P value < 0.05 was considered significant. Magnesium deficiency increased the chance of elevated %HbA1c by 5.893-fold (P = 0.041). Three main dietary patterns were identified: mixed (MDP), unhealthy (UDP), and healthy (HDP). UDP also increased the chance of elevated %HbA1c levels (P = 0.034). T2DM individuals’ who presented magnesium deficiency had a higher chance of elevated %HbA1c levels (8.312-fold) and those in the lowest quartile (Q) of the UDP (Q1: P = 0.007; Q2: P = 0.043) had a lower chance of elevated %HbA1c levels. However, the lower quartiles of the HDP were associated with a greater chance of alterations in the %HbA1c level (Q1: P = 0.050; Q2: P = 0.044). No association was observed between MDP and the variables studied. Magnesium deficiency and UDP were associated with a higher chance of inadequate glycemic control in T2DM individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Luk AO, Lau ES, So WY, Ma RC, Kong AP, Ozakiet R, Chow FC, Chan JC (2014) Prospective study on the incidences of cardiovascular-renal complications in chinese patients with young-onset type 1 and type 2 diabetes. Diabetes Care 37(1):149–157. https://doi.org/10.2337/dc13-1336

    Article  CAS  PubMed  Google Scholar 

  2. Martínez MLR, Gómez-Díaz RA, González ALV, González RM, Becerra MCS, Rio SLGD, Cruz M, Wacher-Rodarte NH, Pacheco RAR, Aburto VHB (2020) Association between glycemic control and dietary patterns in patients with type 2 diabetes in a Mexican institute. Nutrition 78:110901. https://doi.org/10.1016/j.nut.2020.110901

    Article  CAS  PubMed  Google Scholar 

  3. Frank LK, Kröger J, Schulze MB, Bedu-Addo G, Mockenhaupt FP, Danquah I (2014) Dietary patterns in urban Ghana and risk of type 2 diabetes. Br J Nutr 112(1):89–98. https://doi.org/10.1017/S000711451400052X

    Article  CAS  PubMed  Google Scholar 

  4. Mozaffarian D, Appel LJ, Van Horn L (2011) Components of a cardioprotective diet: new insights. Circulation 123(24):2870–2891. https://doi.org/10.1161/CIRCULATIONAHA.110.968735

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ajala O, English P, Pinkney J (2013) Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes1-3. Am J Clin Nutr 97(3):505–516. https://doi.org/10.3945/ajcn.112.042457

    Article  CAS  PubMed  Google Scholar 

  6. Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J (2010) Yancy WS Jr (2012) Macronutrients, food groups, and eating patterns in the management of diabetes: a systematic review of the literature. Diabetes Care 35(2):434–445. https://doi.org/10.2337/dc11-2216

    Article  CAS  Google Scholar 

  7. Volpe SL (2013) Magnesium in disease prevention and overall health. Adv Nutr 4(3):378S-383S. https://doi.org/10.3945/an.112.003483

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Mathe N, Pisa PT, Johnson JA, Johnson ST (2016) Dietary patterns in adults with type 2 diabetes predict cardiometabolic risk factors. Can J Diabetes 40(4):296–303. https://doi.org/10.1016/j.jcjd.2015.11.006

    Article  PubMed  Google Scholar 

  9. WHO Consultation on obesity (1999: Geneva, Switzerland) & World Health Organization (2000) Obesity: preventing and managing the global epidemic: report of a WHO consultation. Available online: https://apps.who.int/iris/handle/10665/42330. (Accessed on 18 Sept 2021)

  10. World Health Organization (2008) Waist circumference and waist-hip ratio: report of a WHO expert consultation. Available online: https://www.who.int/publications/i/item/9789241501491. (Accessed 18 Sept 2021)

  11. Lohman TJ, Roache AF, Martorell R (1992) Anthropometric standardization reference manual.Med Sci Sports Exerc. Available online: https://doi.org/10.1249/00005768-199208000-00020. (Accessed on 27 Sept 2021)

  12. Costa SS, Pereira AC, Passos EA, Alves Jdo P, Garcia CA, Araujo RG (2013) Multivariate optimization of an analytical method for the analysis of dog and cat foods by ICP OES. Talanta 108:157–164. https://doi.org/10.1016/j.talanta.2013.03.002

    Article  CAS  PubMed  Google Scholar 

  13. Lowenstein FW, Stanton MF (1986) Serum magnesium levels in the United States, 1971–1974. J Am Coll Nutr 5(4):399–414. https://doi.org/10.1080/07315724.1986.10720143

    Article  CAS  PubMed  Google Scholar 

  14. Friedewald WT, Levy RI, Fredrickson DS (1972) Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 18(6):499–502

    Article  CAS  PubMed  Google Scholar 

  15. Oliveira JEPD, Montenegro Junior RM, Vencio S (2017) Diretrizes da Sociedade Brasileira de Diabetes 2017–2018. Editora Clannad, São Paulo

  16. Precoma DB, Oliveira GMM, Simao AF, Dutra OP, Coelho OR, Izar MCO, Póvoa RMS, Giuliano ICB, Filho ACA, Machado CA, Scherr C, Fonseca FAH, Filho RDS, Carvalho T, Azevum A, Esposcatte R, Nascimento BR, Brasil DP, Soares PB, Villela RM, et al (2019) Atualização da diretriz de prevenção cardiovascular da Sociedade Brasileira de Cardiologia- 2019. Arq Bras Cardiol. Available online: https://aop-diretriz-prevencao-cardiovascular-portugues.pdf. (cardiol.br) (Accessed on 30 Sept 2021)

  17. Moshfegh AJ, Rhodes DG, Baer DJ, Murayi T, Clemens JC, Rumpler WV, Paul DR, Sebastian RS, Kuczynski KJ, Ingwersen LA, Staples RC, Cleveland LE (2008) The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. Am J Clin Nutr 88(2):324–332. https://doi.org/10.1093/ajcn/88.2.324

    Article  CAS  PubMed  Google Scholar 

  18. Institute of Medicine (2005) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (Macronutrients). Washington, DC: The National Academies Press. Available online: https://nap.nationalacademies.org/catalog/10490/dietary-reference-intakes-for-energy-carbohydrate-fiber-fat-fatty-acids-cholesterol-protein-and-amino-acids. (Accessed on 2 Feb 2022)

  19. Institute of Medicine (2006) Dietary reference intakes: the essential guide to nutrient requirements. Washington, DC: The National Academies Press. Available online: https://nap.nationalacademies.org/catalog/11537/dietary-reference-intakes-the-essential-guide-to-nutrient-requirements. (Accessed on 29 Jan 2022)

  20. Willett W (2012) Issues in analysis and presentation of dietary data. In: Willet W (ed) Nutritional Epidemiology, 3rd edn. Oxford University Press, Oxford, pp 305–333. https://doi.org/10.1093/acprof:oso/9780199754038.003.0013

  21. Oliveira SR, Fisberg RM, Marchioni DM, Baltar VT (2015) Dietary patterns for meals of Brazilian adults. Br J Nutr 114(5):822–828. https://doi.org/10.1017/S0007114515002445

    Article  CAS  Google Scholar 

  22. Studart EPM, Arruda SPM, Sampaio HAC, Passos TU, Carioca AAF (2018) Dietary patterns and glycemic indexes in type 2 diabetes patients. Rev Nutr 31:1–12. https://doi.org/10.1590/1678-98652018000100001

    Article  CAS  Google Scholar 

  23. Newby PK, Tucker KL (2004) Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 62(5):177–203. https://doi.org/10.1301/nr.2004.may.177-203

    Article  CAS  PubMed  Google Scholar 

  24. Marchioni DML, Latorre MR, Eluf-Neto J, Wünsch-Filho V, Fisberg RM (2005) Identification of dietary patterns using factor analysis in an epidemiological study in São Paulo. Sao Paulo Med J 123(3):124–127. https://doi.org/10.1590/S1516-31802005000300007

    Article  PubMed  Google Scholar 

  25. Vaz JDS, Buffarini R, Kac G, Bielemann RM, Oliveira I, Menezes AB, Assunção MCF (2018) Dietary patterns are associated with blood lipids at 18-year-olds: a cross-sectional analysis nested in the 1993 Pelotas (Brazil) birth cohort. Nutrition 17(1):77. https://doi.org/10.1186/s12937-018-0389-z

    Article  CAS  Google Scholar 

  26. Bertinato J, Wu Xiao C, Ratnayake WM, Fernandez L, Lavergne C, Wood C, Swist E (2015) Lower serum magnesium concentration is associated with diabetes, insulin resistance, and obesity in South Asian and white Canadian women but not men. Food Nutr Res 59:25974. https://doi.org/10.3402/fnr.v59.25974

    Article  PubMed  Google Scholar 

  27. Bertinato J, Wang KC, Hayward S (2017) Serum magnesium concentrations in the Canadian population and associations with diabetes, glycemic regulation, and insulin resistance. Nutrients 9(3):296. https://doi.org/10.3390/nu9030296

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Kim DJ, Xun P, Liu K, Loria C, Yokota K, Jacobs DR Jr, He K (2010) Magnesium intake in relation to systemic inflammation, insulin resistance, and the incidence of diabetes. Diabetes Care 33(12):2604–2610. https://doi.org/10.2337/dc10-0994

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Arpaci D, Tocoglu AG, Ergenc H, Korkmaz S, Ucar A, Tamer A (2015) Associations of serum Magnesium levels with diabetes mellitus and diabetic complications. Hippokratia 19(2):153–157

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Campbell AP (2017) DASH eating plan: an eating pattern for diabetes management. Diabetes Spectr 30(2):76–81. https://doi.org/10.2337/ds16-0084

    Article  PubMed  Google Scholar 

  31. Sievenpiper JL, Dworatzek PD (2013) Food and dietary pattern-based recommendations: an emerging approach to clinical practice guidelines for nutrition therapy in diabetes. Can J Diabetes 37(1):51–57. https://doi.org/10.1016/j.jcjd.2012.11.001

    Article  PubMed  Google Scholar 

  32. American Diabetes Association (2022) 3. Prevention or delay of type 2 diabetes and associated comorbidities: standards of medical care in diabetes—2022. Diabetes Care 45:S39–S44

    Article  Google Scholar 

  33. Dekker LH, van Dam RM, Snijder MB, Peters RJ, Dekker JM, de Vries JH, de Boer EJ, Schulze MB, Stronks K, Nicolaou M (2015) Comparable dietary patterns describe dietary behavior across ethnic groups in the Netherlands, but different elements in the diet are associated with glycated hemoglobin and fasting glucose concentrations. J Nutr 145(8):1884–1891. https://doi.org/10.3945/jn.114.207472

    Article  CAS  PubMed  Google Scholar 

  34. Hakeem R, Shiraz M, Riaz M, Fawwad A, Basit A (2018) Association of dietary patterns with glycated haemoglobin among Type 2 diabetics in Karachi, Pakistan. J Diabetol 9(2):59–64. https://https://doi.org/10.4103/jod.jod_4_18

  35. Marshall JA, Hoag S, Shetterly S, Hamman RF (1994) Dietary fat predicts conversion from impaired glucose tolerance to NIDDM. The San Luis Valley Diabetes Study. Diabetes Care 17(1):50–56. https://doi.org/10.2337/diacare.17.1.50

  36. de la Monte SM, Tong M, Lawton M, Longato L (2009) Nitrosamine exposure exacerbates high fat diet-mediated type 2 diabetes mellitus, non-alcoholic steatohepatitis, and neurodegeneration with cognitive impairment. Mol Neurodegener 4:54. https://doi.org/10.1186/1750-1326-4-54

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Kellow NJ, Savige GS (2013) Dietary advanced glycation end-product restriction for the attenuation of insulin resistance, oxidative stress and endothelial dysfunction: a systematic review. Eur J Clin Nutr 67(3):239–248. https://doi.org/10.1038/ejcn.2012.220

    Article  CAS  PubMed  Google Scholar 

  38. Wolk A (2017) Potential health hazards of eating red meat. J Intern Med 281(2):106–122. https://doi.org/10.1111/joim.12543

    Article  CAS  PubMed  Google Scholar 

  39. Buscemi S, Nicolucci A, Mattina A, Rosafio G, Massenti FM, Lucisano G, Galvano F, Amodio E, Pellegrini F, Barile AM, Maniaci V, Grosso G, Verga S, Sprini D, Rini GB (2013) Association of dietary patterns with insulin resistance and clinically silent carotid atherosclerosis in apparently healthy people. Eur J Clin Nutr 67(12):1284–1290. https://doi.org/10.1038/ejcn.2013.172

    Article  CAS  PubMed  Google Scholar 

  40. Sadiya A, Mnla R (2019) Impact of food pattern on glycemic control among type 2 diabetic patients: a cross-sectional study in the United Arab Emirates. Diabetes Metab Syndr Obes 12:1143–1150. https://doi.org/10.2147/DMSO.S209320

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Sarmento RA, Antonio JP, de Miranda IL, Nicoletto BB, Almeida JC (2017) Eating patterns and health outcomes in patients with type 2 diabetes. J Endocr Soc 2(1):42–52. https://doi.org/10.1210/js.2017-00349

    Article  CAS  PubMed  Google Scholar 

  42. Satija A, Bhupathiraju SN, Rimm EB, Spiegelman D, Chiuve SE, Borgi L, Willett WC, Manson JE, Sun Q, Hu FB (2016) Plant-based dietary patterns and incidence of type 2 diabetes in US men and women: results from three prospective cohort studies. PLoS Med 13(6):e1002039. https://doi.org/10.1371/journal.pmed.1002039

    Article  PubMed  PubMed Central  Google Scholar 

  43. Odegaard AO, Koh WP, Butler LM, Duval S, Gross MD, Yu MC, Yuan JM, Pereira MA (2011) Dietary patterns and incident type 2 diabetes in Chinese men and women the Singapore Chinese Health Study. Diabetes Care 34(4):880–885. https://doi.org/10.2337/dc10-2350

    Article  PubMed  PubMed Central  Google Scholar 

  44. Morimoto A, Ohno Y, Tatsumi Y, Mizuno S, Watanabe S (2012) Effects of healthy dietary pattern and other lifestyle factors on incidence of diabetes in a rural Japanese population. Asia Pac J Clin Nutr 21(4):601–608

  45. Martín-Peláez S, Fito M, Castaner O (2020) Mediterranean diet effects on type 2 diabetes prevention, disease progression, and related mechanisms. A review. Nutrients 12(8):2236. https://doi.org/10.3390/nu12082236

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Fardet A, Rock E (2015) From a reductionist to a holistic approach in preventive nutrition to define new and more ethical paradigms. Healthcare (Basel) 3(4):1054–1063. https://doi.org/10.3390/healthcare3041054

    Article  PubMed  Google Scholar 

  47. Perez A, Rojas P, Carrasco F, Basfi-Fer K, Perez-Bravo F, Codoceo J, Inostroza J, Galgani JE, Gilmore LA, Ruz M (2018) Association between zinc nutritional status and glycemic control in individuals with well-controlled type-2 diabetes. J Trace Elem Med Biol 50:560–565. https://doi.org/10.1016/j.jtemb.2018.03.019

    Article  CAS  PubMed  Google Scholar 

  48. Sampaio FA, Feitosa MM, Sales CH, Silva DMC, Cruz KJC, Oliveira FE, Colli C, Marreiro DN (2014) Influencia de magnesio en la bioquímicadel hierro y el estrés oxidativo en pacientes con diabetes tipo 2. Nutr Hosp 30:570–576. https://doi.org/10.3305/nh.2014.30.3.7333

    Article  Google Scholar 

  49. Shah M, Vasandani C, Adams-Huet B, Garg A (2018) Comparison of nutrient intakes in South Asians with type 2 diabetes mellitus and controls living in the United States. Diabetes Res Clin Pract 138:47–56

    Article  PubMed  Google Scholar 

  50. Brandão-Lima PN, Carvalho GB, Santos RKF, Santos BDC, Dias-Vasconcelos NL, Rocha VS, Barbosa KBF, Pires LV (2018) Intakes of zinc, potassium, calcium, and magnesium of individuals with type 2 diabetes mellitus and the relationship with glycemic control. Nutrients 10(12):1948. https://doi.org/10.3390/nu10121948

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This work was supported by the National Council for Scientific and Technological Development (CNPq) for the financial support (Call MCTIC/CNPq No. 28/2018–Process: 432298/2018–5), to the Foundation for the Support of Research and Technological Innovation of the State of Sergipe (FAPITEC/SE: PROMOB–88881 157882/2017–01; and PROEF–88887.157406/2017–00), and to the Coordination for the Improvement of Higher Education Personnel (CAPES—Finance Code 001).

Author information

Author notes

  1. Cinthia Fontes da Silva Santos and Beatriz da Cruz Santos contributed equally to this work.

Authors and Affiliations

  1. Nutrition Sciences Post-Graduation Program, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil

    Cinthia Fontes da Silva Santos, Beatriz da Cruz Santos, Juliana de Souza Oliveira, Cynthia Batista Santos, Aline Rocha Reis, Ramara Kadija Fonseca Santos & Liliane Viana Pires

  2. Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, Marechal Rondon Avenue, S/n – Jardim Rosa Elze, ZIP: 49100-000, São Cristóvão, Sergipe, Brazil

    Cinthia Fontes da Silva Santos, Beatriz da Cruz Santos, Gabrielli Barbosa de Carvalho, Juliana de Souza Oliveira, Cynthia Batista Santos, Aline Rocha Reis, Ramara Kadija Fonseca Santos, Paula Nascimento Brandão-Lima & Liliane Viana Pires

  3. Nutrition in Public Health Post-Graduation Program, Faculty of Public Health, University of São Paulo, São Paulo, Brazil

    Gabrielli Barbosa de Carvalho & Paula Nascimento Brandão-Lima

  4. Nucleus of Competence in Oil, Gas and Biofuels–NUPEG, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil

    Silvânio Silvério Lopes da Costa

  5. Chemistry Post-Graduation Program, Chemistry Institute, Federal University of Bahia, Salvador, Bahia, Brazil

    Samir Hipólito dos Santos

  6. Department of Nutrition, Federal University of Sergipe, Lagarto, Sergipe, Brazil

    Vivianne de Sousa Rocha

Authors
  1. Cinthia Fontes da Silva Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Beatriz da Cruz Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gabrielli Barbosa de Carvalho
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juliana de Souza Oliveira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cynthia Batista Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aline Rocha Reis
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ramara Kadija Fonseca Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Paula Nascimento Brandão-Lima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Silvânio Silvério Lopes da Costa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Samir Hipólito dos Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Vivianne de Sousa Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Liliane Viana Pires
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The authors C.F.S.S.; B.C.S, and L.V.P. designed the study. All authors contributed to data collection and analysis. The article was written by the author C.F.S.S.; B.C.S, and L.V.P. All authors contributed to the critical writing and review of the article. L.V.P. contributed with supervision, project administration and funding acquisition.

Corresponding author

Correspondence to Liliane Viana Pires.

Ethics declarations

Competing Interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 999 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Santos, C.F.d., Santos, B.d., de Carvalho, G.B. et al. Magnesium Status and Dietary Patterns Associated with Glycemic Control in Individuals with Type 2 Diabetes Mellitus. Biol Trace Elem Res 201, 5152–5161 (2023). https://doi.org/10.1007/s12011-023-03601-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12011-023-03601-7

Keywords

Search

Navigation