Coenzyme Q10 supplementation for diabetes and its complications: an overview


  • David Mantle



coenzyme Q10, diabetes, glycaemic control, vascular dysfunction, statins, fatty liver disease


This article reviews the potential role of dietary supplementation with coenzyme Q10 (CoQ10) for the management of patients with type 2 diabetes. The rationale for supplementation with CoQ10 is based on its key roles in cellular energy metabolism and as an antioxidant, and its potential mediation of oxidative stress and inflammation, which have been implicated in the pathogenesis of diabetes. Randomised controlled clinical trials have demonstrated that supplementation with CoQ10 can significantly improve glycaemic control, as well as improving vascular dysfunction. Supplementation with CoQ10 may be of particular importance in type 2 diabetics prescribed statins and in those with fatty liver disease. Supplemental CoQ10 is usually well tolerated, with no significant adverse effects reported in long-term use. The importance of product quality and bioavailability cannot be over-emphasised, since this may be a factor in the disparity of findings from clinical trials supplementing CoQ10.


De Blasio MJ, Huynh K, Qin C, et al. Therapeutic targeting of oxidative stress with CoQ10 counteracts exaggerated diabetic cardiomyopathy in a mouse model of diabetes with diminished PI3K(p110α) signaling. Free Radic Biol Med 2015;87:137–47.

Mao Z, Wu JH, Dong T, Wu MX. Additive enhancement of wound healing in diabetic mice by low level light and topical CoQ10. Sci Rep 2016;6:20084.

Zhang YP, Mei S, Yang J, et al. Acute hypoglycemia induces painful neuropathy and the treatment of CoQ10. J Diabetes Res 2016:4593052.

Mezawa M, Takemoto M, Onishi S, et al. The reduced form of CoQ10 improves glycemic control in patients with type 2 diabetes: an open label study. Biofactors 2012;38:416–21.

Weber C, Bysted A, Hilmer G. The CoQ10 content of the average Danish diet. Int J Vitam Nutr Res 1997;67:123–9.

Petersen KF, Befroy D, Dufour S. Mitochondrial dysfunction in the elderly: possible role in insulin resistance. Science 2003;300:1140–2.

Naudi A, Jove M, Ayala V, et al. Cellular dysfunction in diabetes as maladaptive response to mitochondrial oxidative stress. Exp Diabetes Res 2012:696215.

El-Ghoroury EA, Raslan HM, Badawy EA, et al. Malondialdehyde and CoQ10 in platelets and serum in type II diabetes: correlation with glycemic control. Blood Coagul Fibrinolysis 2009;20:248–51.

Eriksson JG, Forsen TJ, Mortensen SA, Rohde M. Effect of CoQ10 administration on metabolic control in patients with type 2 diabetes mellitus. Biofactors 1999;9:315–18.

Hodgson JM, Watts GF, Playford DA, Burke V, Croft KD. CoQ10 improves blood pressure and glycaemic control in subjects with type 2 diabetes. Eur J Clin Nutr 2002;56:1137–42.

Kolahdouz-Mohammadi R, Hosseinzadeh-Attar M, Eshraghian M, et al. Effect of CoQ10 supplementation on metabolic status of type 2 diabetic patients. Minerva Gastroenterol Dietol 2013;59:231–5.

Zahedi H, Eghtesadi S, Seifirad S, et al. Effects of CoQ10 supplementation on lipid profiles and glycemic control in patients with type 2 diabetes. J Diabetes Metab Disord 2014;13:81–9.

Hosseinzadeh-Attar M, Mohammadi R, Eshraghian IM, et al. Reduction in asymmetric dimethylarginine plasma levels by CoQ10 supplementation in patients with type 2 diabetes. Minerva Endocrinol 2015;40:259–66.

Akbari-Fakhrabadi M, Ghotrom A, Khosravi H, et al. Effect of CoQ10 on oxidative stress, glycemic control and inflammation in diabetic neuropathy: a double blind randomised clinical trial. Int J Vitam Nutr Res 2014;84:252–60.

Raygan F, Rezawandi Z, Dadkhah Tehrani S, Farrokhian A, Asemi Z. The effects of CoQ10 administration on glucose homeostasis parameters, lipid profiles, biomarkers of inflammation and oxidative stress in patients with metabolic syndrome. Eur J Nutr 2015;55:2357–64.

Mehrdadi P, Mohammadi R, Alipoor E, et al. Effect of CoQ10 supplementation on circulating levels of adipokine adipolin in overweight and obese patients with type 2 diabetes. Exp Clin Endocrinol Diabetes 2016;125:156–62.

Amin MM, Asaad GF, Salam RF, El-Abhar HS, Arbid MS. Novel CoQ10 antidiabetic mechanisms underlie its positive effect: modulation of insulin and adiponectin receptors, tyrosine kinase, glucose transporters and visfatin in insulin resistant/diabetic rats. PloS One 2014;9:e89169.

Ates O, Bileu H, Keies S, et al. Plasma CoQ10 levels in type 2 diabetics with retinopathy. Int J Ophthalmol 2013;6:675–9.

Montano SJ , Grinier J, Nair D, et al. Glutaredoxin mediated redox effects of CoQ10 treatment in type 1 and type 2 diabetes patients. BBA Clin 2015;4:14–20.

Hamilton SJ, Chew GT, Watts GF. CoQ10 improves endothelial dysfunction in statin treated type 2 diabetic patients. Diabetes Care 2009; 32:810–12.

Mortensen SA, Rosenfeldt F, Kumar A, et al. The effect of CoQ10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomised double blind trial. JACC Heart Fail 2014;2:641–9.

Alehagen U, Johansson P, Bjornstadt M, Rosén A, Dahlström U. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and CoQ10 supplementation: a 5 year prospective randomised double blind placebo controlled trial among elderly Swedish citizens. J Cardiol 2013;167:1860–6.

Brault M, Ray J, Gomez YH, Mantzoros CS, Daskalopoulou SS. Statin treatment and new onset diabetes: a review of proposed mechanisms. Metabolism 2014;63:735–45.

Cederberg H, Stančáková A, Yaluri N, Modi S, Kuusisto J, Laakso M. Increased risk of diabetes with statin treatment is associated with impaired insulin sensitivity and insulin secretion: a 6 year follow up study of the METSIM cohort. Diabetologia 2015;58:1109–17.

Chan DC, Pang J, Watts DF. Pathogenesis and management of the diabetogenic effect of statins: a role for adiponectin and CoQ10? Curr Atheroscler Rep 2015;17:472–5.

Gansean S, Ito MK. CoQ10 ameliorates reduction in GLUT4 transporter expression induced by simvastatin in 3T3-L1 adipocytes. Metab Syndr Relat Disord 2013;11:251–5.

Ahmed M. Non-alcoholic fatty liver disease in 2015. World J Hepatol 2015;7:1450–9.

Hazelhurst JM, Woods C, Marjot T, Cobbold JF, Tomlinson JW. Non- alcoholic fatty liver disease and diabetes. Metabolism 2016;65:1096–108.

Francque SM, Graff D, Kwantan WJ. NAFLD and cardiovascular risk: pathophysiological mechanisms and implications. J Hepatol 2016;65: 425–43.

Sirbu O, Florida M, Dascalita P, Şorodoc V, Şorodoc L. NAFLD from the cardiologist perspective. Anatol J Cardiol 2016;16:534–41.

Lee BJ, Tseng YF, Yen CH, Lin PT. Effects of CoQ10 supplementation (300 mg/day) on antioxidation and anti-inflammation in coronary artery disease patients during statins therapy: a randomized, placebo-controlled trial. Nutr J 2013;12:142–8.

Fan L, Feng Y, Chen GC, Qin LQ, Fu CL, Chen LH. Effects of CoQ10 supplementation on inflammatory markers: a systematic review and meta-analysis of randomised controlled trials. Pharmacol Res 2017;119: 128–36.

Spahis S, Delvin E, Borys J, Levy E. Oxidative stress as a critical factor in NAFLD. Antioxid Redox Signal 2017;26:519–41.

Yesilova Z, Yaman H, Oktenli C, et al. Systemic markers of lipid peroxidation and antioxidants in patients with non-alcoholic fatty liver disease. Am J Gastroenterol 2005;100:850–5.

Farhangi MA, Alipour B, Jafarvand E, Khoshbaten M. Oral CoQ10 supplementation in patients with NAFLD: effects on serum vaspin, chemerin, pentraxin, insulin resistance and oxidative stress. Arch Med Res 2014;45:589–95.

Farsi F, Mohammadshalin M, Aalavinejad P, Rezazadeh A, Zarei M, Engali KA. Functions of CoQ10 supplementation on liver enzymes, markers of inflammation and adipokines in patients with NAFLD: a double blind randomized placebo controlled clinical trial. J Am Coll Nutr 2016; 35:346–53.

Hosoe K, Kitano M, Kishida H, Kubo H, Fujii K, Kitahara M. Study on the safety and bioavailability of ubiquinol after single and 4-week multiple oral administration to healthy volunteers. Regul Toxicol Pharmacol 2007;47:19–28.

Hidaka T, Fujii K, Funahashi I, Fukutomi N, Hosoe K. Safety assessment of CoQ10. Biofactors 2008;32:199–208.

Engelsen J, Nielsen JD, Hansen KF. Effect of CoQ10 and Ginkgo biloba on warfarin dosage in patients on long term warfarin treatment. A double blind placebo controlled cross-over trial. Ugeaskr Laeger 2003;165:1868–71.

Ezekowitz JA. Time to energise CoQ10 for patients with heart failure? JACC Heart Fail 2014;2:650–2.