Research has highlighted a breadth of benefits for adequate magnesium intake, and one study by Schwalfenberg et al noted the mineral is an essential element in over 300 enzymatic reactions, including those related to numerous metabolic pathways.¹ They also noted that evidence supports the use of magnesium in the prevention and treatment of many common conditions, including migraines, hyperlipidemia, asthma, premenstrual syndrome, and various cardiac arrhythmias.
Another important addition on that list is diabetes, according to Benjamin Nwosu, MD, chief of endocrinology at Cohen Children’s Medical Center and researcher at the Feinstein Institutes for Medical Research in New York.
“Magnesium is a cofactor for some enzymatic activities in glycolysis, as well as the regulation of insulin action, particularly the post-receptor actions of insulin in relation to insulin-mediated glucose uptake,” he said. “Thus, there is evidence of post-receptor insulin resistance and poor glucose utilization in the cells of individuals with prolonged magnesium deficiency. This worsening of post-receptor insulin resistance could lead to prolonged hyperglycemia and type 2 diabetes.”
Dr. Nwosu said that this is important because magnesium-induced post-receptor insulin resistance and the risk for type 2 diabetes could be reversed with adequate magnesium supplementation.
What the Research Says
In addition to the Scientifica study, other research has highlighted the impact of magnesium deficiency on diabetes risk. These include:
A 2011 meta-analysis by Dong et al of 13 cohort studies that included more than 536,000 participants found a significant inverse association between magnesium intake and type 2 diabetes risk.² This was not significantly modified by geographic region, follow-up length, sex, or family history of the condition.
A 2019 study by ELDerwawi et al looking at oral magnesium supplementation on glycemic response among type 2 diabetes patients found that daily administration of 250 mg of elemental magnesium for three months showed significant improvement in HbA1C insulin levels compared to a control group.³
A 2017 population-based cohort study by Kieboom et al assessing serum magnesium levels and association with prediabetes found that low levels were associated with increased risk, suggesting a potential causal role of magnesium in the development of diabetes, likely due to the mineral’s role in insulin resistance.⁴
A 2021 study by Piuri et al noted that magnesium deficiency is frequently seen in patients with obesity and/or type 2 diabetes and metabolic syndrome. Not only would adequate levels lower risk of diabetes, researchers reported, it would also improve blood pressure regulation, and prevent hyperglycemia and hypertriglyceridemia.⁵
Studies like these emphasize the strong connection between magnesium deficiency and diabetes or metabolic syndrome risks, said Dr. Nwosu. But the seemingly obvious fix of prescribing or recommending magnesium supplements is not quite as straightforward as it appears.
Challenges for Clinicians
Based on research such as this, should every patient with diabetes and prediabetes be given magnesium supplementation? That is a difficult question to answer, said Dr. Nwosu, and at this point, there are no prescribing guidelines for magnesium.
The reason is that most studies focus on the measurement of total serum magnesium, which means the magnesium in the bloodstream, he explained. Free or bioavailable magnesium — which is what the body actually uses — is not easy to measure. In other words, it is one thing to have a certain amount of magnesium in the body, but another to determine how much is being absorbed and utilized.
“Therefore, basing clinical decision on total magnesium levels might be misleading in situations where the free fraction of magnesium is deficient,” Dr. Nwosu said.
Focus on Food
Due to the challenges surrounding measurement, absorption, and subsequent supplementation levels, a first-line approach may be to suggest consuming foods rich in magnesium. Not only does this give those with diabetes and prediabetes more of the mineral, but it also boosts health in other ways due to higher vitamin and fiber levels. These foods include:
pumpkin seeds
chia seeds
almonds
spinach
cashews
peanuts
soy milk
black beans
edamame
baked potato with skin
brown rice
plain low-fat yogurt
salmon
bananas
Eating more of these foods is not good only for those with diabetes at play, according to Susan Yanovski, MD, co-director in the Office of Obesity Research at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — these choices can benefit everyone.
“Some research estimates that up to 80% of people in the US may be deficient in magnesium, and although more studies need to be done on the effects of this deficiency, we know that in general, we’re simply not getting enough of this essential mineral,” she said.
The recommended daily allowance of magnesium for adults is 420 mg for men and 320 mg for women. Seeds are an especially good choice for hitting daily totals — just an ounce of pumpkin seeds has 156 mg, for example, while chia seeds have 111 mg per ounce.⁶
Ripple Effect: Sleep, Digestion, and Heart Health
“Considering that magnesium plays a critical role in a breadth of functions like sleep, cellular health, digestion, immune system function, and heart function, deficiency is a major concern,” said Dr. Yanovski. That means focusing on adequate intake may not only improve diabetes risk and symptoms, but also boost patient health overall.
For those with diabetes, bettering even one of these variables can have a significant impact. For example, those with diabetes who get fewer than seven hours of sleep nightly find it harder to manage their condition, according to the CDC.⁷
Too little sleep can increase insulin resistance, the CDC reports, and other sleep-related complications for those with diabetes can include higher likelihood of eating foods high in carbs and sugar, more difficulty losing weight, reduced immune system function, increased blood pressure, and higher risk of depression and anxiety.
In terms of digestion, the CDC notes that it is common for people with diabetes to experience issues such as nausea, heartburn, and bloating, and high blood sugar can lead to gastroparesis, a condition that affects how the body digests food.8 Additionally, the CDC indicates that someone with diabetes is twice as likely to have heart disease or experience a stroke compared to those without the condition — and the longer someone has diabetes, the more likely they are to develop heart disease.⁹
Clinical Takeaways
Adequate magnesium can be a bridge toward deeper sleep, better digestion, and improved heart health, creating a long-term ripple effect for those with diabetes that can be significant.
That means magnesium involves not just lowering risk of developing type 2 diabetes, said Dr. Nwosu, but also offering those with the condition a way to improve quality of life and better management of common comorbidities.
