This study investigates the prevalence of hypomagnesemia in adults with type 2 diabetes mellitus (T2DM) in Riyadh, Saudi Arabia, and examines its association with various metabolic parameters. Conducted as a cross-sectional study at King Saud University, Riyadh, it included 294 Saudi adults aged 25 to 65 years, comprising 119 T2DM patients, 80 prediabetics, and 95 nondiabetic controls. Participants underwent physical examinations, and fasting blood samples were analyzed for glucose, glycated hemoglobin (HbA1c), lipid profile, and serum magnesium levels. Statistical analysis revealed that lower magnesium levels were significantly more prevalent in T2DM patients (1.65 ± 4.9 mg/L) compared to prediabetes (2.48 ± 5.2 mg/L) and controls (2.9 ± 5.4 mg/L; P < .001). T2DM patients with magnesium deficiency exhibited higher levels of fasting glucose (11.2 ± 3.9 mmol/L), HbA1c (8.6 ± 2.1 mmol/L), and triglycerides (2.1 ± 0.9 mmol/L), along with increased insulin resistance (Homeostatic Model Assessment of Insulin Resistance = 6.6) and decreased insulin sensitivity (Quantitative Insulin Sensitivity Check Index = 0.29). Magnesium levels correlated negatively with glucose (R = -0.58) and HbA1c (R = -0.61). The area under the curve for serum magnesium in predicting HbA1c > 5.7 was 0.88, and for HbA1c ≥ 6.5, it was 0.91, indicating high diagnostic accuracy. These findings suggest that magnesium deficiency significantly impacts the metabolic profile of T2DM patients in Riyadh. Therefore, routine monitoring of magnesium levels is crucial in diabetes management, and further research is needed to explore the benefits of magnesium supplementation in T2DM care.

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