Hyperglycemia and Severe Hypomagnesemia

[Lev, MSN, RN, NP]

I admitted a middle aged patient the other day with a magnesium level of 0.3 mg/dL. She was fairly stable and only had mild tachycardia. She was treated with 4g IV magnesium and her mg level increased to 1.7 mg/dL. The patient had been discharged from the hospital the previous day after an admission for severe hyperglycemia (>500 on admission). Her HbA1c was 14. She hadn't even had time to fill her insulin prescription. She went home and that night she felt very cold so she went to bed, covering herself with a ton of blankets even though she usually has hot flashes and is always hot. Then she woke up and felt so nauseous and just felt something was not right, so she went back to the hospital and they found her magnesium had tanked. I looked back at her labs from the previous admission and there was one time when her magnesium was a little low, but it was treated and it increased to 1.9. There must be a connection between the hyperglycemia and hypomagnesemia.

[Esme12, ASN, BSN, RN]

This may help.....Hypomagnesemia in Patients with Type 2 Diabetes

[Lev, MSN, RN, NP]

This may help.....Hypomagnesemia in Patients with Type 2 Diabetes

Thanks this helps

[h=3]Renal Causes

[/h][h=4]Enhanced Filtered Load.[/h]In the patient with diabetes, the ultrafilterable Mg load may be enhanced by glomerular hyperfiltration, recurrent excessive volume repletion after hyperglycemia-induced osmotic diuresis, recurrent metabolic acidosis associated with diabetic ketoacidosis, and hypoalbuminemia (50). The last two conditions may increase the serum ionized Mg fraction and, hence, ultrafilterable Mg load and subsequent urinary loss. In addition, it is conceivable that significant microalbuminuria and overt proteinuria among patients with diabetic nephropathy may contribute to renal Mg wasting as a result of protein-bound magnesium loss.

[Esme12, ASN, BSN, RN]

:) You're welcome. I think reading it for your self helps.