Effects of Canagliflozin on Serum Magnesium in Patients With Type 2 Diabetes Mellitus: A Post Hoc Analysis of Randomized Controlled Trials

INTRODUCTION: The objective of this study was to evaluate the effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on serum magnesium in hypomagnesemic patients with type 2 diabetes. METHODS: This post hoc analysis was based on pooled data from four placebo-controlled studies of canagliflozin (N = 2313). The proportion of patients with baseline serum magnesium <0.74 mmol/L who achieved serum magnesium ≥0.74 mmol/L at week 26 was evaluated. RESULTS: At week 26, canagliflozin 100 and 300 mg increased serum magnesium versus placebo in patients with baseline serum magnesium <0.74 mmol/L (17.0% and 19.0% vs 3.9%) and ≥0.74 mmol/L (4.9% and 7.0% vs −1.4%). More patients with baseline serum magnesium <0.74 mmol/L had serum magnesium ≥0.74 mmol/L at week 26 with canagliflozin 100 and 300 mg versus placebo (74.1% and 80.6% vs 28.8%). CONCLUSIONS: Canagliflozin was associated with normalization of serum magnesium in hypomagnesemic patients with type 2 diabetes, potentially leading to improved cardiometabolic outcomes. Clinical trial registration: ClinicalTrials.gov Identifiers, NCT01081834, NCT01106677, NCT01106625, NCT01106690.