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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Identifying High-Yield Groups for the Detection of Low Serum Magnesium in Diabetes: A Nationally Representative Study of Korean Adults

  1. 1Department of Emergency Medicine, Yeungnam University College of Medicine, Daegu 42415, Republic of Korea

Abstract

Background/Objectives: Diabetes predisposes to magnesium deficiency, yet serum magnesium is not routinely measured. Using an unselected national sample, I sought a practical criterion for predicting which adults with diabetes are more likely to have low serum magnesium (<0.75 mmol/L) and examined clinical correlates. Methods: I analyzed 5798 adults aged ≥19 years from the 2024 Korea National Health and Nutrition Examination Survey using survey-weighted methods. Diagnostic yield was the proportion tested with low serum magnesium. Criteria combining guideline-based glycated hemoglobin (HbA1c) and estimated glomerular filtration rate (eGFR) thresholds were compared by diagnostic yield and Youden index. Results: Low serum magnesium occurred in 10.7% of adults with diabetes versus 2.4% without diabetes; those with diabetes accounted for 41.0% of all cases. Among criteria with a Youden index of at least 0.20, HbA1c ≥8% or eGFR <60 mL/min/1.73 m2 required the fewest tests and had the highest diagnostic yield (21.7%). This group comprised 17.6% of adults with diabetes but 35.7% of cases. Low serum magnesium was associated with HbA1c ≥8% (odds ratio 3.10; 95% confidence interval 1.64–5.84) and albuminuria (2.10; 1.17–3.75), largely consistently across sensitivity analyses. Exploratory analyses also identified associations with depressive symptoms and fatigue. Dietary magnesium density did not differ by magnesium status. Conclusions: Testing adults with diabetes who had HbA1c ≥8% or eGFR <60 mL/min/1.73 m2 identified low serum magnesium about twice as efficiently as testing all adults with diabetes.

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BibTeX
@article{chung2026identifying,
  title = {{Identifying High-Yield Groups for the Detection of Low Serum Magnesium in Diabetes: A Nationally Representative Study of Korean Adults}},
  author = {Hansol Chung},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208164},
  url = {https://www.mdpi.com/2077-0383/15/20/8164},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Identifying High-Yield Groups for the Detection of Low Serum Magnesium in Diabetes: A Nationally Representative Study of Korean Adults
AU  - Hansol Chung
PY  - 2026
DA  - 2026/10/20
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208164
UR  - https://www.mdpi.com/2077-0383/15/20/8164
AB  - Background/Objectives: Diabetes predisposes to magnesium deficiency, yet serum magnesium is not routinely measured. Using an unselected national sample, I sought a practical criterion for predicting which adults with diabetes are more likely to have low serum magnesium (<0.75 mmol/L) and examined clinical correlates. Methods: I analyzed 5798 adults aged ≥19 years from the 2024 Korea National Health and Nutrition Examination Survey using survey-weighted methods. Diagnostic yield was the proportion tested with low serum magnesium. Criteria combining guideline-based glycated hemoglobin (HbA1c) and estimated glomerular filtration rate (eGFR) thresholds were compared by diagnostic yield and Youden index. Results: Low serum magnesium occurred in 10.7% of adults with diabetes versus 2.4% without diabetes; those with diabetes accounted for 41.0% of all cases. Among criteria with a Youden index of at least 0.20, HbA1c ≥8% or eGFR <60 mL/min/1.73 m2 required the fewest tests and had the highest diagnostic yield (21.7%). This group comprised 17.6% of adults with diabetes but 35.7% of cases. Low serum magnesium was associated with HbA1c ≥8% (odds ratio 3.10; 95% confidence interval 1.64–5.84) and albuminuria (2.10; 1.17–3.75), largely consistently across sensitivity analyses. Exploratory analyses also identified associations with depressive symptoms and fatigue. Dietary magnesium density did not differ by magnesium status. Conclusions: Testing adults with diabetes who had HbA1c ≥8% or eGFR <60 mL/min/1.73 m2 identified low serum magnesium about twice as efficiently as testing all adults with diabetes.
SN  - 2077-0383
ER  -