Decreased serum concentration of ionized calcium in insulin-dependent human diabetes mellitus.

Low serum ionized calcium concentrations were observed in twenty-five insulin dependent diabetic outpatients compared with twenty-three age-matched normal subjects: mean 1.16 mmol/l (SEM 0.01) versus 1.20 mmol/l (0.01), P less than 0.002. Despite this, there was no compensatory increase in serum concentrations of immunoreactive parathyroid hormone, nor was serum total calcium decreased in the diabetic patients. Serum magnesium was significantly decreased in the diabetics compared with normals: mean 0.75 mmol/l versus 0.83 mmol/l, P less than 0.001. No significant correlation could be demonstrated between serum magnesium and serum ionized calcium or parathyroid hormone in the diabetic patients. Since no significant correlations were observable between serum ionized calcium and indices of diabetes control, the etiology and pathogenesis of decreased serum calcium ion in insulin-dependent human diabetes mellitus remain unknown.