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Insomnia is increasing alarmingly among the population. Micronutrient fluctuations have been shown to effect insulin secretion, period of circadian cycle and quality of sleep in all ages. This study is aimed to identify the impact of magnesium and potassium supplementation on insomnia severity and duration, and insulin resistance, quality of life, sleep hormones, serum magnesium and potassium levels. Moreover, the study will help to find out the link between insomnia and micronutrients among patients of diabetes mellitus so that the burden of the disease in the society could be reduced.
Sleep is the essential component to maintain good health of an individual. Insomnia is defined as a condition that affects an individual by inability to get sufficient quality sleep or problem in maintaining sleep that is important for healthy functioning, performance and well being. Insomnia can exist in healthy individual or comorbidly with other medical diseases. Latest researches indicate that intolerance of glucose in the body, resistance to insulin hormone, decreased acute response of insulin to glucose and increased chances of having type 2 diabetes are reasons for reduced or interrupted sleep. Several electrolytes and minerals influence the sleep cycle. Magnesium is important in regulation of central nervous system excitability, through ion channel conductivity. Magnesium is a muscle relaxant and inducer of the deeper sleep. Hypomagnesemia is a common feature in patients with type 2 diabetes. Although diabetes can induce hypomagnesemia, magnesium deficiency has also been proposed as a risk factor for type 2 diabetes. Magnesium supplementation improves sleep efficiency, sleep time and sleep onset latency, early morning awakening, and insomnia objective measures such as the concentration of serum renin, melatonin, and serum cortisol, in older adults. High ambient potassium levels have been shown to shorten the period of circadian rhythms in a variety of organisms. Little is known about the effects of dietary mineral nutrients on human sleep quality. Potassium depletion has been shown to cause glucose intolerance, which is associated with impaired insulin secretion . Recently, there has been growing evidence from both animal and human studies indicating that high sodium and low potassium intakes are associated with a high risk of insulin resistance or diabetes.
The Study is aimed to:
1. Akhuwat Health Services, Lahore Duration of Study: 18 months (after the approval of synopsis) Sample Size: is 280 and with expected 20% drop out: 320 Sampling Technique: Non probability purposive sampling
Inclusion Criteria:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PLACEBO group | Placebo Comparator | Placebo treatment: starch tablets (250 mg) |
|
| Magnesium group | Experimental | Magnesium group: Magnesium gluconate (250 mg) |
|
| Potassium group | Experimental | Potassium group: Potassium chloride (250 mg) |
|
| Magnesium + Potassium group | Experimental | Magnesium + Potassium group: Magnesium gluconate (250 mg) + Potassium chloride (250 mg) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Magnesium and/ or Potassium | Other | Magnesium and/ or potassium supplements will be provided to patients of diabetes mellitus with insomnia |
|
| Measure | Description | Time Frame |
|---|---|---|
| Effects of magnesium and/ or potassium supplementation on insomnia severity patients with diabetes mellitus | Insomnia Severity Index (ISI) will be used to assess and categorize the insomnia among patients with diabetes mellitus, before and after the intervention | 60 days |
| Effects of magnesium and/ or potassium on insulin resistance among insomnia patients with diabetes mellitus | Homeostatic model assessment for insulin resistance (HOMA-IR) will be used to measure the insulin resistance before and after the Mg, K supplementation among insomniac patients with diabetes mellitus. Insulin will be measured through ELISA technique. | 60 days |
| Effects of magnesium and/ or potassium on sleep hormones (melatonin, cortisol) among insomniac patients with diabetes mellitus. | Sleep hormones (melatonin, cortisol) will be measured before and after the intervention, through ELISA technique, among insomniac patients with diabetes mellitus. | 60 days |
| Effect of magnesium and/ or potassium on serum electrolytes (Mg, K) among insomnia patients with diabetes mellitus | Serum magnesium and/ potassium (in blood) will be measured through chemistry analyzer, before and after the Mg, K supplementation among insomniac patients with diabetes mellitus | 60 days |
| Measure | Description | Time Frame |
|---|---|---|
| Effect of magnesium and/ or potassium on quality of life (QOL) among insomnia patients with diabetes mellitus | WHOQOL-BREF will be used to measure quality of life before and after the Mg, K supplementation, among insomniac patients with diabetes mellitus. | 60 days |
| Gender and age based response to magnesium and/ or potassium on insomnia patients with diabetes mellitus |
| Measure | Description | Time Frame |
|---|---|---|
| Effect of magnesium and/ or potassium on quality liver function tests (LFTs) among insomnia patients with diabetes mellitus | Liver function tests (ALT, AST) will measured before and after the Mg, K supplementation among insomniac patients with diabetes mellitus | 60 Days |
Inclusion Criteria:
• Patients of diabetes mellitus with insomnia
Exclusion Criteria:
Individuals with the following conditions will not be included as participants, patients of diabetes mellitus with insomnia with
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sidra Khalid | Contact | 0923347498338 | sidrakhalid.uaf@gmail.com | |
| Shahid Bashir, PhD | Contact | 092423200865 | 5967 | shahid.bashir@rsmi.uol.edu.pk |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Akhuwat Health Services | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39410716 | Derived | Khalid S, Mehboob R, Bokhari SS, Ali M, Shabbir A, Mehboob K, Adnan H, Karami MM, Shalabi H, Alshehri B. Comparative Efficacy of Magnesium and Potassium Towards Cholesterol and Quality of Life in Patients With Type 2 Diabetes Mellitus: A Randomised Single-Blinded Controlled Clinical Trial. Endocrinol Diabetes Metab. 2024 Nov;7(6):e511. doi: 10.1002/edm2.511. |
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Patients data will be kept confidential and their identity will not be revealed
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| ID | Term |
|---|---|
| D007319 | Sleep Initiation and Maintenance Disorders |
| D003920 | Diabetes Mellitus |
| D007333 | Insulin Resistance |
| ID | Term |
|---|---|
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D008274 | Magnesium |
| D011188 | Potassium |
| ID | Term |
|---|---|
| D008673 | Metals, Alkaline Earth |
| D004602 | Elements |
| D007287 | Inorganic Chemicals |
| D019565 | Metals, Light |
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Participants will be divided into 4 groups and will receive 4 different treatments at same time
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It will be single blind study, Participants will not be aware of the treatment group, they are receiving
Gender and age based responses of Mg, K supplementation will be compared among insomniac patients with diabetes mellitus |
| 60 days |
| The University of Lahore | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
|
| D001523 |
| Mental Disorders |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D006946 | Hyperinsulinism |
| D008670 |
| Metals |
| D008672 | Metals, Alkali |