Abstract
Posttransplantation hypomagnesemia is common and predicts diabetes. Magnesium improves glycemic control in diabetics and insulin sensitivity in insulin resistant subjects.
We aimed to assess the effectiveness of oral magnesium for improving glycemic control and insulin sensitivity at three months posttransplantation.
We conducted a single-centre, open-label, randomised parallel group study. We included adults with serum magnesium < 1.7 mg/dL within two weeks after kidney transplantation. We randomized participants to 450 mg magnesium oxide up to three times daily or no treatment. The primary endpoint was the mean difference in fasting glycemia. Secondary endpoints were the mean difference in AUC of glucose during an oral glucose tolerance test and insulin resistance measured by HOMA-IR. Analyses were on intention-to-treat basis.
In patients randomised to magnesium oxide (N=27) versus no treatment (N=27), fasting glycemia on average was 11.5 mg/dL lower (95% CI 1.7 to 21.3; p=0.02). There was no difference between the two groups neither for two hour AUC where the mean value was 1164mg/dL/min (95%CI -1884 to 4284; p=0.45) lower in the treatment group nor for HOMA-IR.
Magnesium supplements modestly improved fasting glycemia without effect on insulin resistance. Higher baseline glycemia among patients in the control group may have driven the positive outcome.(ClinicalTrials.gov number: NCT01889576).
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http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1111%2Ftri.12287
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