Featured article | August 2026
Magnesium Supplementation: Is It Time for Diabetes Guidelines to Consider Its Inclusion?
Tremblay, G. (2015). *Journal of Orthomolecular Medicine. 30*(2), 107–116.
This review article examines magnesium intake from food sources, factors contributing to deficiency, supplementation and safety, and its potential relevance for use in patients with type 2 diabetes, including the challenges of assessing magnesium status.
Discussed in the article:
Magnesium is required for cellular energy production
- Magnesium participates in the activity of more than 300 enzymes, particularly those involved in energy metabolism.
- Magnesium must bind to adenosine triphosphate (ATP) before cells can use ATP as a source of energy.
Magnesium supports insulin signalling and glucose metabolism
- Magnesium is required for an effective response to insulin. Low magnesium inside cells can interfere with insulin signalling, weakening the cell’s response to insulin.
- Observational studies have shown that higher magnesium intake has been associated with lower insulin resistance.
Diabetes can increase magnesium loss
- Insulin helps the kidneys retain magnesium. When insulin levels are too low or the body is resistant to insulin, more magnesium may be lost in the urine.
- Hyperglycemia (elevated blood sugar) can independently increase renal magnesium excretion.
Higher magnesium intake is associated with lower diabetes risk
- Large meta-analyses involving hundreds of thousands of participants have found that higher magnesium intake is associated with a lower risk of developing type 2 diabetes.
- Among people with prediabetes, those with greater magnesium intake have been found to have a lower risk of progressing to type 2 diabetes.
Serum magnesium may not reflect total-body magnesium status
- Serum magnesium is tightly regulated and correlates poorly with total-body magnesium stores.
- A normal serum magnesium result does not necessarily mean that the body’s magnesium stores are adequate.
- Magnesium status should be assessed by considering laboratory results alongside lifestyle, medical history, symptoms, and response to supplementation.
Magnesium supplementation may improve some markers of glucose metabolism
- A meta-analysis of nine randomized controlled trials found that 4–16 weeks of magnesium supplementation reduced fasting plasma glucose and increased HDL cholesterol compared with controls. The average magnesium dose was 360 mg/day.
- A six-month trial in insulin-resistant adults without diabetes found improvements in fasting glucose and insulin sensitivity with magnesium supplementation.
Why it matters
Magnesium is involved in several processes directly relevant to type 2 diabetes. Diabetes itself may also promote magnesium loss, creating the potential for a self-reinforcing relationship between poor magnesium status and impaired glucose regulation.
“There is sufficient evidence to begin routinely recommending magnesium supplementation to diabetic patients once contraindications are ruled out. With magnesium’s robust safety profile and growing evidence of its therapeutic effect, the potential benefits outweigh the potential risks.”
