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

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.