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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Post-sepsis low magnesium status and newly recorded diabetes: a propensity score–matched cohort study

  • Yu-Li Pang1
  • Li-Chen Chang2
  • Ping-Heng Tan1,3
  • Su-Zhen Wu4
4 affiliations
  1. 1Department of Anesthesiology, Chi Mei Medical Center
  2. 2Department of Anesthesiology, E-Da Hospital, I-Shou University
  3. 3School of Medicine, College of Medicine, National Sun Yat-sen University
  4. 4Department of Anesthesiology, Chi Mei Hospital
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Abstract

Background: Whether low magnesium status after sepsis is associated with subsequent diabetes remains uncertain. We examined the association between post-sepsis magnesium status and newly recorded diabetes among adult sepsis survivors.

Methods: We conducted a retrospective multicenter cohort study using the TriNetX Global Collaborative Network. Adults with a qualifying magnesium measurement between 2010 and 2023 and a history of sepsis were classified as having low magnesium (< 1.80 mg/dL) or normal magnesium (1.80–2.20 mg/dL). Patients with diabetes or hemoglobin A1c (HbA1c) ≥ 6.5% before the index date were excluded, and a 90-day landmark was applied. After 1:1 propensity score matching, 15,201 patients remained in each group. The primary outcome was a diabetes composite outcome, defined as newly recorded type 2 diabetes mellitus (T2DM) or HbA1c ≥ 6.5%. Secondary outcomes included the individual composite components, all-cause mortality, other diabetes diagnoses, and HbA1c ≥ 9.0%. Outcomes were assessed from day 90 through day 730 after the index date.

Results: The diabetes composite occurred in 3.31% of the low-magnesium group and 2.38% of controls (absolute risk difference, 0.93 percentage points; hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.25–1.63). Associations were consistent for newly recorded T2DM (HR, 1.38; 95% CI, 1.19–1.59) and HbA1c ≥ 6.5% (HR, 1.51; 95% CI, 1.21–1.89). Low magnesium was also associated with higher all-cause mortality (HR, 1.22; 95% CI, 1.12–1.33) and other diabetes diagnoses (HR, 1.78; 95% CI, 1.12–2.84), whereas HbA1c ≥ 9.0% was not significantly increased. The association with the primary outcome remained generally consistent across several sensitivity analyses and when severe magnesium deficiency (< 1.5 mg/dL) defined the exposure (HR, 1.53; 95% CI, 1.26–1.85).

Conclusions: Among adult sepsis survivors without recognized diabetes, low magnesium status was associated with a modestly higher subsequent risk of newly recorded diabetes and mortality. These findings support magnesium as a potential post-sepsis risk marker but do not establish causality.

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Cite

BibTeXRIS
BibTeX
@article{pang2026postsepsis,
  title = {{Post-sepsis low magnesium status and newly recorded diabetes: a propensity score–matched cohort study}},
  author = {Yu-Li Pang and Li-Chen Chang and Ping-Heng Tan and Su-Zhen Wu},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = nov,
  doi = {10.3389/fendo.2026.2017989},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.2017989/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Post-sepsis low magnesium status and newly recorded diabetes: a propensity score–matched cohort study
AU  - Yu-Li Pang
AU  - Li-Chen Chang
AU  - Ping-Heng Tan
AU  - Su-Zhen Wu
PY  - 2026
DA  - 2026/11/04
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.2017989
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.2017989/full
AB  - Background: Whether low magnesium status after sepsis is associated with subsequent diabetes remains uncertain. We examined the association between post-sepsis magnesium status and newly recorded diabetes among adult sepsis survivors.  Methods: We conducted a retrospective multicenter cohort study using the TriNetX Global Collaborative Network. Adults with a qualifying magnesium measurement between 2010 and 2023 and a history of sepsis were classified as having low magnesium (< 1.80 mg/dL) or normal magnesium (1.80–2.20 mg/dL). Patients with diabetes or hemoglobin A1c (HbA1c) ≥ 6.5% before the index date were excluded, and a 90-day landmark was applied. After 1:1 propensity score matching, 15,201 patients remained in each group. The primary outcome was a diabetes composite outcome, defined as newly recorded type 2 diabetes mellitus (T2DM) or HbA1c ≥ 6.5%. Secondary outcomes included the individual composite components, all-cause mortality, other diabetes diagnoses, and HbA1c ≥ 9.0%. Outcomes were assessed from day 90 through day 730 after the index date.  Results: The diabetes composite occurred in 3.31% of the low-magnesium group and 2.38% of controls (absolute risk difference, 0.93 percentage points; hazard ratio [HR], 1.43; 95% confidence interval [CI], 1.25–1.63). Associations were consistent for newly recorded T2DM (HR, 1.38; 95% CI, 1.19–1.59) and HbA1c ≥ 6.5% (HR, 1.51; 95% CI, 1.21–1.89). Low magnesium was also associated with higher all-cause mortality (HR, 1.22; 95% CI, 1.12–1.33) and other diabetes diagnoses (HR, 1.78; 95% CI, 1.12–2.84), whereas HbA1c ≥ 9.0% was not significantly increased. The association with the primary outcome remained generally consistent across several sensitivity analyses and when severe magnesium deficiency (< 1.5 mg/dL) defined the exposure (HR, 1.53; 95% CI, 1.26–1.85).  Conclusions: Among adult sepsis survivors without recognized diabetes, low magnesium status was associated with a modestly higher subsequent risk of newly recorded diabetes and mortality. These findings support magnesium as a potential post-sepsis risk marker but do not establish causality.
SN  - 1664-2392
ER  -