Potential Effects of Magnesium on Gestational Diabetes Mellitus

Yıl 2019, , 371 - 378, 20.09.2019

Esra Tuncer , Hülya Yardımcı

https://doi.org/10.21763/tjfmpc.609668

Öz

Magnesium, which is the cofactor for many
enzymes in the body is involved in important mechanisms such as regulation of
body temperature, synthesis of nucleic acid and protein. Magnesium also plays
an important role in the metabolism of carbonhydrate and lipids. Its role in
such situations as diabetes mellitus is remarkable. Magnesium is suggested to
play a role in glucose homeostasis due to the effects of insulin secretion and
glucose uptake by cells. Although not in all cases, diabetes mellitus is often
thought to be associated with magnesium deficiency. In addition, the inverse
relationship between dietary magnesium intake and the risk of type 2 diabetes
mellitus is indicated. Gestational diabetes mellitus, a type of diabetes
mellitus, is a common complication during pregnancy. Gestational diabetes
mellitus, which negatively affects health of both maternal and newborn is
associated with increased risk of macrosomia, preeclampsia, caesarean delivery
and neonatal hypoglycemia. Maternal magnesium deficiency could be a risk factor
both for maternal and newborn health. Hypomagnesemia in pregnancy is reported
to be a potential contributing factor to problems such as hypertensive
disorders, gestational diabetes mellitus, preterm delivery and intra uterine
growth retardation. In this review, potential effects of magnesium on
pregnancy, diabetes mellitus and gestational diabetes mellitus will be
discussed.

Vücutta birçok enzimin kofaktörü olan
magnezyum, vücut sıcaklığının düzenlenmesi, nükleik asit ve protein sentezi
gibi önemli mekanizmalarda görev almaktadır. Karbonhidrat ve lipit
metabolizmasında da görev aldığı için diabetes mellitus gibi durumlarda rolü
dikkat çekmektedir. İnsülin sekresyonu ve hücrelerin glukoz alımında etkisi
nedeni ile magnezyumun glukoz homeostazında rol aldığı düşünülmektedir. Tüm
vakalarda olmamakla birlikte, genellikle diabetes mellitusun magnezyum
eksikliğiyle ilişkili olduğu düşünülmektedir. Ayrıca diyetle magnezyum alımı ve
tip 2 diabetes mellitus riski arasında ters ilişki olduğu belirtilmektedir. Diabetes
mellitusun bir türü olan gestasyonel diabetes mellitus (GDM) gebelik döneminde
sık karşılaşılan bir komplikasyondur. Hem anne hem bebek sağlığını olumsuz
yönde etkileyen gestasyonel diabetes mellitus; makrozomi, preeklampsi, sezaryen
doğum, neonatal hipoglisemi riskinde artış ile ilişkilendirilmektedir. Maternal
magnezyum eksikliği hem annenin hem de bebeğin sağlığı için risk oluşturabilir.
Gebelikte hipomagnezeminin hipertansif bozukluklar, gestasyonel diabetes
mellitus, preterm doğum, intrauterin büyüme geriliği gibi sorunlara katkıda
bulunabilen bir faktör olduğu belirtilmektedir. Bu derlemede, magnezyumun
gebelik dönemi, diabetes mellitus ve gestasyonel diabetes mellitus üzerindeki
olası etkileri tartışılacaktır.

Anahtar Kelimeler

Magnesium, pregnancy, diabetes mellitus, gestational diabetes mellitus

Kaynakça

• 1. Makrides M, Crosby DD, Bain E, Crowther CA. Magnesium supplementation in pregnancy. Cochrane Database Syst Rev 2014;(4). doi:10.1002/14651858.CD000937.pub2.
• 2. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies). Scientific opinion on dietary reference values for magnesium. EFSA Journal 2015;13(7):4186. doi:10.2903/j.efsa.2015.4186.
• 3. Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: The National Academies Press; 1997. doi:10.17226/5776. Erişim: https://www.nap.edu/catalog/5776/ dietary-reference-intakes-for-calcium-phosphorus-magnesium-vitamin-d-and-fluoride. Erişim tarihi: 15.01.2019.
• 4. Arikan GM, Panzitt T, Gucer F, Scholz HS, Reinisch S, Haas J, et al. Course of maternal serum magnesium levels in low-risk gestations and in preterm labor and delivery. Fetal Diagn Ther 1999;14(6):332-336.
• 5. T.C. Sağlık Bakanlığı, Sağlık Araştırmaları Genel Müdürlüğü. Beslenme Durumu ve Alışkanlıklarının Değerlendirilmesi Sonuç Raporu, Türkiye Beslenme ve Sağlık Araştırması 2010. Erişim: https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/ kitaplar/diger-kitaplar/TBSA-Beslenme-Yayini.pdf. Erişim tarihi:15.01.2019.
• 6. Dalton LM, NiFhloinn DM, Gaydadzhieva GT, Mazurkiewicz OM, Leeson H, Wright CP. Magnesium in pregnancy. Nutr Rev 2016;74(9):549-557. doi: 10.1093/nutrit/nuw018
• 7. Baloch GH, Shaikh K, Jaffery MH, Abbas T, Das CM, Devrajani BR, et al. Serum magnesium level during pregnancy. World Applied Sciences Journal 2012;17(8):1005-1008.
• 8. Almonte RA, Heath DL, Whitehall J, Russell MJ, Patole S, Vink R. Gestational magnesium deficiency is deleterious to fetal outcome. Biol Neonate 1999;76(1):26-32.
• 9. Rosner JY, Gupta M, McGill M, Xue X, Chatterjee PK, Yoshida-Hay M, et al. Magnesium deficiency during pregnancy in mice impairs placental size and function. Placenta 2016;39:87-93. doi: 10.1016/j.placenta.2016.01.009.
• 10. Enaruna NO, Ande A, Okpere EE. Clinical significance of low serum magnesium in pregnant women attending the University of Benin Teaching Hospital. Niger J Clin Pract 2013;16(4):448-453. doi: 10.4103/1119-3077.116887.
• 11. Sarıyıldız L, Akdağ T. Hamilelikte gözlenen bazı hematolojik ve metabolik değişiklikler. J Clin Anal Med 2013;4(3):245-248. doi: 10.4328/JCAM.947.
• 12. Zarean E, Tarjan A. Effect of magnesium supplement on pregnancy outcomes: A randomized control trial. Adv Biomed Res 2017 Aug;6:109. doi:10.4103/2277-9175.213879.
• 13. İnci K, Sunay D, Uçkan Ü. Gestasyonel diabetes mellitusta serum magnezyum düzeyleri. Türk Aile Hek Derg 2010;14(2):64-70. doi: 10.2399/tahd.10.064.
• 14. Goker Tasdemir U, Tasdemir N, Kilic S, Abali R, Celik C, Gulerman HC. Alterations of ionized and total magnesium levels in pregnant women with gestational diabetes mellitus. Gynecol Obstet Invest 2015;79(1):19-24. doi: 10.1159/000365813.
• 15. International Diabetes Federation. Diabetes Atlas-8th edition 2017. Erişim: http://www.diabetesatlas.org/. Erişim tarihi: 15.01.2019.
• 16. World Health Organization. Global report on diabetes. Erişim: http://apps.who.int/iris/bitstream/handle/10665/204871/9789241565257_eng.pdf?sequence=1. Erişim tarihi: 15.01.2019.
• 17. World Health Organization. Diabetes. Erişim: http://www.who.int/mediacentre/factsheets/fs312/en/. Erişim tarihi: 15.01.2019.
• 18. Türkiye Diyabet, Hipertansiyon, Obezite ve Endokrinolojik Hastalıklar Prevalans Çalışma-II Grubu. TURDEP-II sonuçlarının özeti. Erişim: http://cdn.istanbul.edu.tr/statics/istanbultip.istanbul.edu.tr/wp-content/uploads/attachments/021_turdep.2.sonuclarinin.aciklamasi.pdf. Erişim tarihi: 15.01.2019.
• 19. Suleymanlar G, Utas C, Arinsoy T, Ates K, Altun B, Altiparmak MR, et al. A population-based survey of Chronic Renal Disease In Turkey-the CREDIT study. Nephrol Dial Transplant 2011;26(6):1862-1871. doi: 10.1093/ndt/gfq656.
• 20. Onat A, Çakır H, Karadeniz Y, Dönmez İ, Karagöz A, Yüksel M, et al. TEKHARF 2013 taraması ve diyabet prevalansında hızlı artış. Arch Turk Soc Cardiol 2014;42(6):511-516. doi: 10.5543/tkda.2014.27543.
• 21. Türkiye Endokrinoloji ve Metabolizma Derneği. TEMD diabetes mellitus ve komplikasyonlarının tanı, tedavi ve izlem kılavuzu-2018. Erişim:http://temd.org.tr/Kilavuzlar. Erişim tarihi: 15.01.2019.
• 22. American Diabetes Association. Lifestyle management: Standards of medical care in diabetes-2018. Diabetes Care 2018;41(Suppl1):S38–50. doi: 10.2337/dc18-S004.
• 23. Swaminathan R. Magnesium metabolism and its disorders. Clin Biochem Rev 2003;24(2):47-66.
• 24. Guerrero-Romero F, Simental-Mendia LE, Hernandez-Ronquillo G, Rodriguez-Moran M. Oral magnesium supplementation improves glycaemic status in subjects with prediabetes and hypomagnesaemia: A double-blind placebo-controlled randomized trial. Diabetes Metab 2015;41(3):202-207. doi: 10.1016/j.diabet.2015.03.010.
• 25. Simmons D, Joshi S, Shaw J. Hypomagnesaemia is associated with diabetes: Not prediabetes, obesity or the metabolic syndrome. Diabetes Res Clin Pract 2010;87(2):261-266. doi: 10.1016/j.diabres.2009.11.003.
• 26. Song Y, He K, Levitan EB, Manson JE, Liu S. Effects of oral magnesium supplementation on glycaemic control in Type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Diabet Med 2006;23(10):1050-1056.
• 27. Simental-Mendia LE, Sahebkar A, Rodriguez-Moran M, Guerrero-Romero F. A systematic review and meta-analysis of randomized controlled trials on the effects of magnesium supplementation on insulin sensitivity and glucose control. Pharmacol Res 2016;111:272-282. doi: 10.1016/j.phrs.2016.06.019.
• 28. Guerrero-Romero F, Rodriguez-Moran M. Magnesium improves the beta-cell function to compensate variation of insulin sensitivity: double-blind, randomized clinical trial. Eur J Clin Invest 2011;41(4):405-410. doi: 10.1111/j.1365-2362.2010.02422.x.
• 29. Del Gobbo LC, Song Y, Elin RJ, Meltzer SJ, Egeland GM. Gestational glucose intolerance modifies the association between magnesium and glycemic variables in mothers and daughters 15 years post-partum. Magnes Res 2012;25(2):54-63. doi: :10.1684/mrh.2012.0308.
• 30. Yang SJ, Hwang SY, Baik SH, Lee KW, Nam MS, Park YS, et al. Serum magnesium level is associated with type 2 diabetes in women with a history of gestational diabetes mellitus: the Korea national diabetes program study. J Korean Med Sci 2014;29(1):84-89. doi: 10.3346/jkms.2014.29.1.84.
• 31. Buchanan TA, Xiang AH, Page KA. Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol 2012;8(11):639-649.
• 32. Lapolla A, Dalfra MG, Fedele D. Management of gestational diabetes mellitus. Diabetes Metab Syndr Obes 2009;2:73-82.
• 33. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Erişim: https://www.who.int/diabetes/publications/Hyperglycaemia_In_Pregnancy/en/. Erişim tarihi: 15.01.2019.
• 34. Chiefari E, Arcidiacono B, Foti D, Brunetti A. Gestational diabetes mellitus: an updated overview. J Endocrinol Invest 2017;40(9):899-909. doi: 10.2174/1871530319666190101130300.
• 35. Mostafavi E, Nargesi AA, Asbagh FA, Ghazizadeh Z, Heidari B, Mirmiranpoor H, et al. Abdominal obesity and gestational diabetes: the interactive role of magnesium. Magnes Res 2015;28(4):116-125. doi:10.1684/mrh.2015.0392.
• 36. HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008;358(19):1991-2002.
• 37. American Diabetes Association. Management of diabetes in pregnancy: Standards of medicalcare in diabetes-2018. DiabetesCare 2018;41(Suppl.1):S137-143. doi: 10.2337/dc18-S013.
• 38. Agha-Jaffar R, Oliver N, Johnston D, Robinson S. Gestational diabetes mellitus: does an effective prevention strategy exist? Nat Rev Endocrinol 2016;12(9):533-546.
• 39. Simmons D. Prevention of gestational diabetes mellitus: Where are we now? Diabetes Obes Metab 2015;17(9):824-834. doi: 10.1111/dom.
• 40. Bardicef M, Bardicef O, Sorokin Y, Altura BM, Altura BT, Cotton DB, et al. Extracellular and intracellular magnesium depletion in pregnancy and gestational diabetes. Am J Obstet Gynecol 1995;172(3):1009-1013. doi: 10.1016/0002-9378(95)90035-7.
• 41. Ertbeg P, Norgaard P, Bang L, Nyholm H, Rudnicki M. Ionized magnesium in gestational diabetes. Magnes Res 2004;17(1):35-38.
• 42. Nabouli MR, Lassoued L, Bakri Z, Moghannem M. Modification of total magnesium level in pregnant Saudi Women developing gestational diabetes mellitus. Diabetes Metab Syndr 2016;10(4):183-185. doi: 10.1016/j.dsx.2016.06.001.
• 43. Asemi Z, Karamali M, Jamilian M, Foroozanfard F, Bahmani F, Heidarzadeh Z, et al. Magnesium supplementation affects metabolic status and pregnancy outcomes in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2015;102(1):222-229. doi: 10.3945/ajcn.114.098616
• 44. Jamilian M, Samimi M, Faraneh AE, Aghadavod E, Shahrzad HD, Chamani M, et al. Magnesium supplementation affects gene expression related to insulin and lipid in patients with gestational diabetes. Magnes Res 2017;30(3):71-79. doi: 10.1684/mrh.2017.0425
• 45. Spätling L, Classen H, Kisters K, Liebscher U, Rylander R, Vierling W, et al. Supplementation of Magnesium in Pregnancy. J Preg Child Health 2017;4:1-6.
• 46. World Health Organization. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. Erişim: https://apps.who.int/iris/bitstream/handle/10665/44703/9789241548335_eng.pdf;jsessionid= 33599396AE86EA82C5117EB918F6ED5F?sequence=1. Erişim tarihi: 27.05.2019.
• 47. American College of Obstetricians and Gynecologists. Magnesium sulfate use in obstetrics. Committee Opinion No. 652. Obstet Gynecol 2016;127:e52–53.
• 48. Rylander R. Treatment with Magnesium in Pregnancy. AIMS Public Health 2015;2(4):804-809. doi: 10.3934/publichealth.2015.4.804.