Effect of Magnesium Supplements on Insulin Secretion After Kidney Transplantation: A Randomized Controlled Trial.
Van Laecke S, Caluwe R, et al.Annals of Transplantation 2017; 22: 524-531.
Aims
To assess whether oral magnesium supplementation improves insulin secretion and glycemic control in kidney transplant recipients with chronic hypomagnesemia.
Interventions
Participants were randomized to receive either magnesium oxide supplementation up to a maximum of 3 times 450 mg daily, versus no supplements.
Participants
52 adult patients >4 months after kidney transplantation, receiving tacrolimus with serial serum magnesium concentrations <1.8 mg/dL.
Outcomes
The primary outcome measured was the mean difference in first-phase insulin release between baseline and 6 months after randomization. Secondary outcomes measured were mean difference in second-phase insulin release, HbA1c and insulin resistance. Impaired fasting glucose, impaired glucose tolerance, and diabetes were also measured.
Follow-up
6 months
CET Conclusions
This study was adequately randomised and analysis was by intention to treat, but no attempt was made to blind patients or assessors. No difference was found in Insulin Response, either first or second phase with or without oral magnesium supplementation. The study however seems small and it is possible that it was underpowered, but no power calculation is presented. The key weakness was a lack of adherence monitoring, so that the lack of increase in serum magnesium in the treatment group might be due to non-adherence.
Data analysis
Modified intention-to-treat analysis
Trial registration
ClinicalTrials.gov - NCT01291030