glycogen and Water-Electrolyte-Imbalance

Over the past decades, hypomagnesemia (serum Mg(2+) <0.7 mmol/L) has been strongly associated with type 2 diabetes mellitus (T2DM). Patients with hypomagnesemia show a more rapid disease progression and have an increased risk for diabetes complications. Clinical studies demonstrate that T2DM patients with hypomagnesemia have reduced pancreatic β-cell activity and are more insulin resistant. Moreover, dietary Mg(2+) supplementation for patients with T2DM improves glucose metabolism and insulin sensitivity. Intracellular Mg(2+) regulates glucokinase, KATP channels, and L-type Ca(2+) channels in pancreatic β-cells, preceding insulin secretion. Moreover, insulin receptor autophosphorylation is dependent on intracellular Mg(2+) concentrations, making Mg(2+) a direct factor in the development of insulin resistance. Conversely, insulin is an important regulator of Mg(2+) homeostasis. In the kidney, insulin activates the renal Mg(2+) channel transient receptor potential melastatin type 6 that determines the final urinary Mg(2+) excretion. Consequently, patients with T2DM and hypomagnesemia enter a vicious circle in which hypomagnesemia causes insulin resistance and insulin resistance reduces serum Mg(2+) concentrations. This Perspective provides a systematic overview of the molecular mechanisms underlying the effects of Mg(2+) on insulin secretion and insulin signaling. In addition to providing a review of current knowledge, we provide novel directions for future research and identify previously neglected contributors to hypomagnesemia in T2DM.

Topics: Blood Glucose; Calcium Channels, L-Type; Diabetes Mellitus, Type 2; Dietary Supplements; Disease Progression; Glucokinase; Glycogen; Glycolysis; Humans; Inflammation; Insulin; Insulin Resistance; Insulin Secretion; Insulin-Secreting Cells; KATP Channels; Liver; Magnesium; Magnesium Deficiency; Obesity; Potassium Channels, Inwardly Rectifying; Sodium Chloride Symporters; Sodium-Potassium-Exchanging ATPase; Water-Electrolyte Imbalance

Topics: Animals; Biological Transport, Active; Calcium Metabolism Disorders; Glycogen; Humans; Hydrogen-Ion Concentration; Hypernatremia; Hypokalemia; Hyponatremia; Magnesium; Membrane Potentials; Muscles; Myoglobinuria; Neuromuscular Diseases; Phosphorus Metabolism Disorders; Potassium Deficiency; Water-Electrolyte Imbalance