EFFECT OF MAGNESIUM SUPPLEMENTATION ON REDUCTION OF HBA1C IN NORMOTENSIVE TYPE 2 DIABETIC PATIENTS TAKING ORAL ANTI-DIABETIC DRUGS

Background: Type 2 diabetes mellitus is commonly accompanied by micronutrient imbalance, and magnesium deficiency has emerged as a potentially important contributor to poor glycemic control. Reduced magnesium levels may impair insulin secretion, worsen insulin resistance, and disrupt glucose metabolism. Although magnesium supplementation has shown potential benefit in improving glycemic indices, locally relevant evidence remains limited, particularly in normotensive patients with type 2 diabetes mellitus receiving oral anti-diabetic drugs without insulin or antihypertensive therapy. Objective: To determine the effect of magnesium supplementation on reduction of HbA1c in normotensive patients with type 2 diabetes mellitus taking oral anti-diabetic drugs. Methods: This comparative analytical study was conducted in the Department of Medicine, Combined Military Hospital, Peshawar, over six months. A total of 180 patients aged 30–65 years with known type 2 diabetes mellitus were enrolled through non-probability consecutive sampling after informed written consent. Only normotensive patients receiving oral anti-diabetic drugs were included. Participants were divided into two equal groups based on treatment status: one group received magnesium oxide 400 mg once daily in addition to routine oral anti-diabetic therapy, while the other continued standard oral anti-diabetic treatment alone. Demographic, clinical, and biochemical data were collected using a structured proforma. Variables included age, sex, duration of diabetes, body mass index, serum magnesium, fasting plasma glucose, and HbA1c. Data were analyzed using SPSS version 26. Independent-samples t-test and chi-square test were applied as appropriate, and p<0.05 was considered statistically significant. Results: A total of 180 participants were analyzed, with 90 patients in each group. Baseline characteristics were comparable between the two groups. Mean age was 52.1 ± 7.8 years in the magnesium group and 51.4 ± 8.2 years in the control group. Baseline HbA1c was 8.61 ± 0.84% in the magnesium group and 8.58 ± 0.81% in the control group. After follow-up, HbA1c decreased to 7.99% in the magnesium group and 8.38% in the control group. Mean HbA1c reduction was significantly greater in the magnesium group (-0.62 ± 0.45%) than in the control group (-0.20 ± 0.40%), with a between-group mean difference of -0.42% (95% CI: -0.54 to -0.30; p=0.001). Hypomagnesemia was present in 34.4% of participants and was associated with significantly higher baseline HbA1c (p<0.001). Conclusion: Magnesium supplementation was associated with better glycemic control and a greater reduction in HbA1c among normotensive patients with type 2 diabetes mellitus receiving oral anti-diabetic therapy. Assessment and correction of magnesium deficiency may offer a simple and affordable adjunctive strategy in diabetes management. Keywords: Blood Glucose; Diabetes Mellitus, Type 2; Hemoglobin A, Glycosylated; Hypoglycemic Agents; Magnesium; Magnesium Oxide; Micronutrients