Potential Positive Effects using Coenzyme Q10 Supplement as Adjuvant Therapy to Gabapentin for Managing Diabetic Neuropathy

Abstract

The most prevalent chronic complication of diabetes mellitus is diabetic neuropathy. The pathogenesis of diabetic neuropathy is exacerbated by hyperglycemia-induced oxidative stress, which causes nerves to deteriorate in a programmed manner. Many clinical trials depend on supplement in an attempt to improve neuropathy symptoms such as (pain & tingling) and patient quality of life, one of them is Coenzyme Q10 which is reported to have an anti-inflammatory and antioxidant effects, and was totally nontoxic and non-reported side effects. This study aimed to evaluate using a Coenzyme Q10 supplement as an adjuvant therapy to gabapentin to improve the clinical symptoms of diabetic neuropathy in relation to its anti-inflammatory and antioxidant effects. This open-label interventional study involved 33 diabetic neuropathy patients divided into two groups: group (1) 16 patients were given 300 mg of gabapentin once a day at evening, plus group (2) 17 patients received 300 mg of gabapentin once a day in the evening plus Coenzyme Q10 200mg once daily. Pre- and post-3 months of treatment, blood samples used to measure metabolic, anti-inflammatory and antioxidant biomarkers (fasting blood glucose, glycated hemoglobin, tumor necrosis factor-α, Iinterleukin-6 & Superoxide dismutase) , as well as the Michigan neuropathy screening instrument for assessment of clinical symptoms. After 3 months of Coenzyme Q10 use, the results showed that the group 2 produced a highly significant change in glycated hemoglobin & fasting blood glucose levels. Meanwhile, there is no significant change in glycated hemoglobin & fasting blood glucose values in patients receiving just gabapentin. Moreover, results showed highly significant differences in Michigan neuropathy screening instrument, tumor necrosis factor-α, iinterleukin-6 & superoxide dismutase between the study groups at the completion of the research. Finally, addition of Coenzyme Q10 to gabapentin for diabetic neuropathy patients result in improving the glycemic control & symptoms of the diabetic neuropathy, as well as decreasing effects of the inflammation in addition to oxidative stress after three months of treatment.

Association between CNR1 gene polymorphisms and susceptibility to diabetic nephropathy in Iraqi patients with T2DM

“…The expression and function of CB receptors have been observed to change in several renal disorders, including DN [ 6 , 7 ]. The main renal consequences of diabetes, such as progressive kidney diseases, are brought on by an increase in ROS generation, which eventually results in DN through various mechanisms [ 8 , 9 ]. The renal cannabinoid receptors have opposing effects on oxidative stress.…”

Effect of Adding Taurine to Gabapentin on Toronto Clinical Neuropathy Score in Patient with Diabetic Neuropathy

“…2 One of the most common microvascular complication of DM is diabetic neuropathy (DN), which is usually undertreated and underdiagnosed in clinical practice. 3 Oxidative stress in conjunction with hyperglycemia is known to activate many pathways such as polyol pathway, hexosamine flux, advanced glycation end products (AGEs), poly (ADP ribose) polymerase, mitogen-activated protein kinases, cyclooxygenase 2 activation, and altered activity of Na + /K + -ATPase which promote neuronal abnormalities and nerve damage. 4,5 Oxidative stress plays a major role in neuropathic pain etiology.…”