Prediabetes, CoQ10 and You?
Prediabetes might very possibly be the most undertreated disease in this country. Too many times patients hear their doctors say, “Don’t worry about it.” when reviewing blood work and encountering a fasting blood glucose sliding above 100mg/dL, but below 125mg/dL. Perhaps what doctors intend to say is, “I don’t have any prescription for you.”
Their provider’s next sentence ought to be, “You can do something for yourself, before it becomes more serious,” before launching into a discussion about the need for properly structured aerobic and resistance exercise, which is the subject of my book, The First Program.
Even though most doctors refrain from writing a prescription, my research has shed light on another intriguing possible consideration — CoQ10. Also known as Coenzyme Q10, this might help some with prediabetes. CoQ10 is a naturally occurring substance which plays a key role in the mitochondria powerplant of aerobic energy production. Inside the mitochondria, COQ10’s job is to transfer electrons in the last part of a chain to regenerate unit power packets known as ATP. As a power generator subunit, CoQ10 alternatively switches between two electrically charged states, ubiquinolone (reduced) and ubiquinone (oxidized). Some classify CoQ10 as an antioxidant because is scoops up free electrons and lower blood levels have been linked to aging, heart failure as well as some rare muscle diseases.
When it comes to diabetes, here’s what we know about CoQ10: the levels correspond to the stages of diabetes. People with healthy glucose metabolisms levels tend to have a predominance of the ubiquinolone (non-oxidized state of CoQ10) whereas diabetics tend to have ubiquinone (the predominantly oxidized state of CoQ10). Prediabetics fall intermediately between the two groups. Researchers have discovered that daily supplementation of CoQ10 raises the level of CoQ10 and can restore the balance back toward the ubiquinolone side. In theory, this should help with glucose and fat control.
Unfortunately, nearly two decades of Type 2 diabetes CoQ10 research studies have yielded only inconsistent results. In some studies, taking CoQ10 not only raised blood CoQ10 levels but also was associated with decreased fasting blood glucose, whereas in other studies, fasting glucose wouldn’t budge. In total, about two dozen studies with a daily intake of 100–200mg/day for up to 3 months seemed to fall into two parallel universes.
That is, extremely confusing until 2017, when Dr. Stojanović published a meta-analysis comparing 18 studies, attempting to sort and tease out the subtle differences between the studies. His analysis suggested CoQ10 can help those diabetics from Asian countries and who are younger than 53. Taking these findings another step in reasoning, one can surmise CoQ10 works best for glucose control at an earlier stage of diabetes. Younger diabetic patients considered in aggregate comparison, reflect an earlier stage of Type 2 diabetes. The pancreas is stronger in earlier stages of diabetes. With advancing time, exhausted pancreatic Beta cells dropout, gradually petering out of insulin.
Could one explanation be that CoQ10 was unable to help Beta cells too far gone in the course of the disease? If that’s the case, then conceivably CoQ10 supplementation even earlier, in the prediabetic phase might be of benefit. Dr. Raygan results of a 2016 study of obese patients with heart problems over eight weeks, showed an average decrease of fasting blood sugar of 5mg/dL over eight weeks, which fell short of statistical significance. There are two potential reasons why this warrants further consideration. The treatment group of CoQ10 had 30 patients, a relatively small group. More patients could have made a difference of 5mg/dL statistically significant. Also, twelve weeks is typically the minimum time period CoQ10 is said to exert results, so the study potentially could have seen statistically significant results given another month and these patients were more chronically ill than typical prediabetics. Dr. Raygan freely admits this short treatment time in the Discussion portion of the same research paper, blaming limited funding.
Getting back to Dr. Stojanović’s second finding regarding Asians, Asian prediabetics tend to have a much greater proportion of thin-body type prediabetes, as opposed to the obese type which dominates developed countries. While this type might have roots in poorer early childhood diet and lower overall protein levels of intake, some have speculated this also is the result of pancreatic insulin production issues. CoQ10 could have a predominant effect on the pancreatic production of insulin — no one knows precisely at this time.
So what does this mean?
Having no major reported adverse effects other than a minor hit to the wallet, 200mg a day of Coenzyme Q10 with meals might be a consideration for someone in the prediabetic phase, especially for the so-called thin-body type prediabetic.
Some references used in this article:
Hidaka T, Fujii K, Funahashi I, et al. Safety assessment of coenzyme Q10 (CoQ10). Biofactors 2008;32:199–208.
Oxidative burden in prediabetic and diabetic individuals: evidence from plasma coenzyme Q10
S. C. Lim, H. H. Tan, S. K. Goh, T. Subramaniam, C. F. Sum, I. K. Tan, B. L. Lee and C. N. Ong
Diabetic Medicine 2006, 23, 1344–1349
The effect of coenzyme Q10 on microcirculatory endothelial function of subjects with type 2 diabetes mellitus
Atherosclerosis 196 (2008) 966–969
S. C. Lim, R Lekshminarayanan, S. K. Goh, T. Subramaniam, C. F. Sum, and Y.Y. Ong‡
Effects of coenzyme Q10 supplementation on metabolic profile in diabetes: a
systematic review and meta-analysis
N. Suksomboon, N. Poolsup and N. Juanak
Journal of Clinical Pharmacy and Therapeutics, 2015, 40, 413–418
Coenzyme Q-10 in Human Health: Supporting Evidence?
Sibu P. Saha, MD; Thomas F. Whayne Jr, MD, PhD
South Med J. 2016;109(1):17–21.
The effects of coenzyme Q10 administration on glucose homeostasis parameters, lipid profiles, biomarkers of inflammation and oxidative stress in patients with metabolic syndrome
F. Raygan, Z. Rezavandi, S. Dadkhah Tehrani, A. Farrokhian, Z. Asemi
Eur J Nutr (2016) 55:2357–2364
