Die Bedeutung von Magnesium für Insulinresistenz, metabolisches Syndrom und Diabetes mellitus – Empfehlungen der Gesellschaft für Magnesium-Forschung e. V.

Zusammenfassung

Mangel an Magnesium (Mg) ist ein wichtiges und häufiges Begleitphänomen bei Patienten mit Diabetes mellitus oder Vorstufen eines Diabetes Typ 2 wie dem Metabolischen Syndrom. Mg-Mangel erhöht das Risiko, einen Diabetes Typ 2 zu entwickeln. Diese Empfehlungen resümieren die gegenwärtigen Kenntnisse zur Physiologie des Mg im Kohlenhydratstoffwechsel und die pathophysiologischen Folgen des Mg-Mangels bei Diabetikern. Diabetiker und Patienten mit dessen Vorstufen profitieren von vier Kategorien der Mg-Wirkmechanismen: Insulin-sensitizing-Effekt, Ca-Antagonismus, Stress-Regulation und Endothel-stabilisierender Effekt. Klinische Studiendaten mit Mg-Comedikation zeigen verminderte Insulinresistenz/verbesserte Glukose-Kontrolle und verminderte vaskuläre Langzeitschäden anhand von Surrogat-Parametern: Hohes Serum-Mg ist assoziiert mit geringerer Retinopathie-Prävalenz; der Schweregrad der Retinopathie korreliert mit dem Mg-Mangel. Hohes Serum-Mg ist auch mit einem verminderten Risiko des Nierenfunktionsverlusts verknüpft. Depression, eine häufige Diabetes-Comorbidität, ist seltener bei hohem Serum-Mg. Es wird ein standardisiertes Konzept zur Diagnose des Mg-Mangels und ein Therapieregime zur Supplementation dieser Patienten vorgelegt. Die Diagnose des Mg-Mangels ist einfach durch Synopsis von Anamnese, Klinik oder/und Laborbefund zu stellen.

Abstract

Magnesium (Mg) depletion is an important and high prevalent condition in patients with diabetes and precursor states of diabetes 2 like metabolic syndrome. Mg deficiency increases the risk of developing diabetes 2. These recommendations compile present data on the physiology of Mg in carbohydrate metabolism and pathopysiological consequences of Magnesium depletion for diabetics. Diabetes patients and candidates benefit from four categories of Mg-effects: insulin sensitizing effect, Ca antagonism, stress regulating and endothelium stabilizing effects. Clinical data with Mg comedication show improvement of insulin-resistance/blood glucose level and reduced long term vascular damages in surrogate parameters. High serum Mg is associated with lower prevalence of retinopathy, severity of retinopathy is associated with the degree of Mg depletion. High serum Mg is also associated with less deterioration of renal function in diabetics. Depression, a comorbiditity of diabetes, is less prevalent in patients with high serum Mg. A standardized regimen for diagnosing Mg-depletion and a regimen for supplementing these patients is outlined. Diagnosis of Mg depletion is simple predominantly by synoptic view of anamnestic, clinical or/and laboratory data.

Schlüsselwörter

Magnesium - Diabetes mellitus - Insulinresistenz

Key words

magnesium - diabetes mellitus - insulin-resistance

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