Prevalence and determinants of hypomagnesemia in type 2 diabetes mellitus: A retrospective cross-sectional study from a resource-limited setting

Hypomagnesemia is a common comorbidity in patients with type 2 diabetes mellitus (T2DM), adversely affecting metabolic control and increasing cardiovascular risk. This study aimed to determine prevalence and independent predictors of hypomagnesemia among Yemeni adults with T2DM. A retrospective analysis was conducted among 487 adults with T2DM attending Al-Raffa Center in Ibb, Yemen, from 2018 to 2023. Demographic, clinical, and biochemical parameters-including serum magnesium (Mg), HbA1c, and lipid profiles-were evaluated. Hypomagnesemia was defined as serum Mg < 1.6 mg/dL. Univariate and multivariate logistic regression analyses were used to identify independent predictors. The cohort had a mean age of 48.3 ± 15.3 years, with 63.4% female participants. Hypomagnesemia was present in 37.2% of patients. Poor glycemic control (HbA1c ≥7%) and LDL ≥100 mg/dL were observed in 42.3%, and 42.1%, respectively. In univariate analysis, hypomagnesemia was significantly associated with older age, female sex, obesity (BMI ≥25 kg/m2), hypertension, diabetes duration ≥5 years, poor glycemic control, khat chewing, elevated LDL, low HDL, and hypertriglyceridemia (all P < .05). Multivariate regression identified obesity (adjusted OR [aOR] 9.32, 95% CI 4.97-18.06), HbA1c ≥7% (aOR 2.85, 95% CI 1.80-4.52), female sex (aOR 1.85, 95% CI 1.20-2.85), hypertension (aOR 1.58, 95% CI 1.02-2.45), diabetes duration ≥5 years (aOR 1.90, 95% CI 1.20-3.00), and LDL ≥100 mg/dL (aOR 1.60, 95% CI 1.02-2.50) as independent predictors. A significant interaction was observed between obesity and poor glycemic control (aOR 3.25, P < .001). The final model demonstrated excellent discrimination (AUC-ROC = 0.86). Hypomagnesemia is highly prevalent among Yemeni adults with T2DM and is independently associated with female sex, obesity, poor glycemic control, hypertension, longer diabetes duration, and elevated LDL. The synergistic effect of obesity and poor glycemic control identifies a particularly high-risk subgroup. Routine assessment of serum Mg should be considered in diabetes management, especially for women and individuals with coexisting obesity and hyperglycemia in resource-limited settings.