The parathyroid hormone- 1,25-dihydroxyvitamin D endocrine system and magnesium status in insulin-dependent diabetes mellitus: current concepts.

Insulin-dependent diabetes mellitus (IDDM) is a chronic metabolic disorder which can induce alterations in bone metabolism (osteopenia) and/or in mineral homeostasis, mainly during growth. Some data suggest that these alterations may be related to low serum magnesium values found in IDDM that induce a functional hypoparathyroid state. In this paper, some aspects are revised relating to altered magnesium and mineral homeostasis in children with IDDM and their possible relationships. The role of osteocalcin, a specific osteoblast protein product, as a biochemical marker of diabetic osteopenia is also discussed. In addition, on the basis of personal experience, it is shown that the deranged parathyroid hormone-vitamin D axis in IDDM is reversed after normalization of magnesium serum levels by oral magnesium. Thus available data suggest that hypomagnesaemia is involved in the genesis of the altered mineral metabolism in children with IDDM.