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Magnesium Supplementation and the Effects on Wound Healing and Metabolic Status in Patients with Diabetic Foot Ulcer: a Randomized, Double-Blind, Placebo-Controlled Trial

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28 February 2020 The Editors-in-Chief are currently investigating this article [Razzaghi, R., Pidar, F., Momen-Heravi, M. et al. Magnesium Supplementation and the Effects on Wound Healing and Metabolic Status in Patients with Diabetic Foot Ulcer: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 181, 207–215 (2018). https://doi.org/10.1007/s12011-017-1056-5] as concerns have been raised about integrity of the clinical trial reported here. There is also an ongoing investigation by the Iranian National Committee for Ethics in Biomedical Researches. Further editorial action will be taken as appropriate once the investigation into the concerns is complete and all parties have been given an opportunity to respond in full.

Abstract

Hypomagnesemia is associated with the development of neuropathy and abnormal platelet activity, both of which are risk factors for diabetic foot ulcer (DFU). This study was carried out to evaluate the effects of magnesium administration on wound healing and metabolic status in subjects with DFU. This randomized, double-blind, placebo-controlled trial was performed among 70 subjects with grade 3 DFU. Subjects were randomly divided into two groups (35 subjects each group) to receive either 250 mg magnesium oxide supplements or placebo daily for 12 weeks. Pre- and post-intervention wound depth and appearance were scored in accordance with the “Wagner-Meggitt’s” wound assessment tool. Fasting blood samples were taken at baseline and after the 12-week intervention to assess related markers. After the 12-week treatment, compared with the placebo, magnesium supplementation resulted in a significant increase in serum magnesium (+0.3 ± 0.3 vs. −0.1 ± 0.2 mg/dL, P < 0.001) and significant reductions in ulcer length (−1.8 ± 2.0 vs. −0.9 ± 1.1 cm, P = 0.01), width (−1.6 ± 2.0 vs. −0.8 ± 0.9 cm, P = 0.02), and depth (−0.8 ± 0.8 vs. −0.3 ± 0.5 cm, P = 0.003). In addition, significant reductions in fasting plasma glucose (−45.4 ± 82.6 vs. −10.6 ± 53.7 mg/dL, P = 0.04), serum insulin values (−2.4 ± 5.6 vs. +1.5 ± 9.6 μIU/mL, P = 0.04), and HbA1c (−0.7 ± 1.5 vs. −0.1 ± 0.4%, P = 0.03) and a significant rise in the quantitative insulin sensitivity check index (+0.01 ± 0.01 vs. −0.004 ± 0.02, P = 0.01) were seen following supplementation of magnesium compared with the placebo. Additionally, compared with the placebo, taking magnesium resulted in significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) (−19.6 ± 32.5 vs. −4.8 ± 11.2 mg/L, P = 0.01) and significant increase in plasma total antioxidant capacity (TAC) concentrations (+6.4 ± 65.2 vs. −129.9 ± 208.3 mmol/L, P < 0.001). Overall, magnesium supplementation for 12 weeks among subjects with DFU had beneficial effects on parameters of ulcer size, glucose metabolism, serum hs-CRP, and plasma TAC levels. Clinical trial registration number: http://www.irct.ir: IRCT201612225623N96

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  • 28 February 2020

    The Editors-in-Chief are currently investigating this article [Razzaghi, R., Pidar, F., Momen-Heravi, M. et al. Magnesium Supplementation and the Effects on Wound Healing and Metabolic Status in Patients with Diabetic Foot Ulcer: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 181, 207–215 (2018). https://doi.org/10.1007/s12011-017-1056-5] as concerns have been raised about integrity of the clinical trial reported here. There is also an ongoing investigation by the Iranian National Committee for Ethics in Biomedical Researches. Further editorial action will be taken as appropriate once the investigation into the concerns is complete and all parties have been given an opportunity to respond in full.

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Acknowledgments

The current study was funded by a grant from the Vice-chancellor for Research, KUMS, and Iran. The authors gratefully acknowledge Dr. Fariba Kolahdooz, who reviewed the manuscript and offered critical comments.

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Authors and Affiliations

  1. Department of Infectious Disease, School of Medicine, Kashan University of Medical Sciences, Kashan, IR, Iran

    Reza Razzaghi, Farangis Pidar & Mansooreh Momen-Heravi

  2. Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, IR, Iran

    Mansooreh Momen-Heravi

  3. Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, IR, Iran

    Fereshteh Bahmani & Zatollah Asemi

  4. Department of Biostatistics, Kashan University of Medical Sciences, Kashan, IR, Iran

    Hossein Akbari

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  1. Reza Razzaghi
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  2. Farangis Pidar
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  3. Mansooreh Momen-Heravi
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  4. Fereshteh Bahmani
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Contributions

ZA contributed in conception, design, statistical analysis, and drafting of the manuscript. RR, FP, MM-H, FB, and HA contributed in data collection and manuscript drafting. All authors approved the final version for submission.

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Correspondence to Zatollah Asemi.

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Razzaghi, R., Pidar, F., Momen-Heravi, M. et al. Magnesium Supplementation and the Effects on Wound Healing and Metabolic Status in Patients with Diabetic Foot Ulcer: a Randomized, Double-Blind, Placebo-Controlled Trial. Biol Trace Elem Res 181, 207–215 (2018). https://doi.org/10.1007/s12011-017-1056-5

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