Association Between Levels of Magnesium and Diabetic Retinopathy in Diabetic Patients with Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis
Abstract
Background/Objectives: Magnesium is an intracellular cation that plays important roles in metabolism and insulin signaling. The evidence of association between magnesium levels and diabetic retinopathy is limited by small study effects. Therefore, this systematic review and meta-analysis aim to update the current evidence. Methods: A comprehensive search of PubMed, ScienceDirect, Google Scholar, and Scopus was conducted from database inception to January 2026 to identify studies examining magnesium levels and diabetic retinopathy. The pooled standardized mean difference in magnesium levels between type 2 diabetic patients with retinopathy and those without retinopathy was estimated using the “meta” package in R software. Results: We included seventeen studies which assessed magnesium levels in 1100 patients with diabetic retinopathy and 1132 diabetic controls without retinopathy. The random-effects model indicated significantly lower magnesium levels in patients with diabetic retinopathy compared to diabetic controls [SMD = −1.19, 95% CI (−1.68; −0.70); p < 0.0001; I2 = 95%]. Sensitivity analysis retained all studies, and no evidence of publication bias was detected. Subgroup analyses demonstrated consistent findings across geographic regions (Asian versus non-Asian), study designs (case–control versus cross-sectional), and magnesium assay methods except enzymatic method. Meta-regression analysis revealed that year of publication (coefficient = 0.061; p = 0.009) and…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,100 participants or records.
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