Fighting Statin-Induced Diabetes with CoQ10May 2017
By Susan Merrill
Statins are cholesterol-lowering drugs sold under trade names such as Lipitor® and Crestor®.
They have been shown to benefit people at risk for heart disease caused by elevated LDL-cholesterol and/or C-reactive protein.
For appropriate patients, statin drugs reduce cardiovascular death and disability rates.1-3
But despite these benefits, evidence suggests that statins, especially high doses of potent statins, may increase the risk, especially in older patients, of developing diabetes.3-6
Compelling data reveals that supplementing with CoQ10 can significantly reduce these glucose control issues.
Facts about Statins and Diabetes
Studies show that some statins, such as rosuvastatin (Crestor®), are associated with a 27% increased risk of developing new-onset type II diabetes.7 This is just one of many studies showing this harmful connection.4-6
One meta-analysis that utilized results from 13 statin studies involving more than 91,000 participants demonstrated an across-the-board increased diabetes risk of 9%,8 and found the highest risk in trials involving older subjects. Another meta-analysis showed that those taking higher doses of statins had a 12% higher risk of developing diabetes compared with subjects receiving “moderate” doses.9
These two alarming studies have made it apparent that older patients on more intensive statin regimens are at the greatest risk of developing diabetes from their treatment.3,10 Naturally, this poses a dilemma for anyone who is on, or considering starting, statin therapy. Is lowering the risk of cardiovascular disease worth the risk of developing diabetes which in turn could, paradoxically, increase the risk of developing cardiovascular disease?6
Experts generally say it’s a worthwhile gamble, because the benefits for cardiovascular disease outweigh the possibility of type II diabetes.8,11 Fortunately, by supplementing with CoQ10, you may be able to continue using statin drugs to lower cardiovascular risk, while minimizing the medication-induced risk of diabetes.
The CoQ10 Connection
One reason statins increase the risk of type II diabetes is because they deplete the body of CoQ10. When cells lack sufficient CoQ10, mitochondrial dysfunction sets in, leading to impaired insulin signaling, which may result in the chronically elevated glucose levels that define diabetes.3
By design, statins interfere with the production of new cholesterol molecules by blocking an enzyme called HMG-CoA reductase.4,12,13 But in the process, they also block a precursor of CoQ10,3,4 interfering with its natural production and resulting in lower CoQ10 blood levels.3
Making matters worse, lowering LDL cholesterol impairs CoQ10 transport into cells. The combination of these effects has been shown to directly reduce blood levels of CoQ10 by as much as 54%.3
Diabetic patients already have lower-than-normal CoQ10 levels. That’s because their body uses up much of its CoQ10 stores in an effort to combat diabetes-induced oxidative stress.2,12 When diabetics are prescribed statin drugs (which is a common occurrence), the further depletion of CoQ10 can be especially harmful.
Supplementing with CoQ10 allows people to derive lipid- and inflammation-lowering benefits from statins while protecting the body against CoQ10 depletion.
Benefits of CoQ10 Supplementation
Experts are increasingly recommending that anyone on statin therapy begin supplementation with CoQ10 in order to reduce the risk and consequences of diabetes.
In addition to replacing depleted stores of CoQ10 in diabetic patients, supplementing with CoQ10 has been found to lower blood-sugar and hemoglobin A1C, a measure of long-term glucose exposure.14
Research also reveals that in fat cells exposed to statins, CoQ10 restores the normal glucose-uptake mechanism that is disrupted by statin therapy.15
CoQ10 has also been proven to reduce diabetes-induced cardiovascular risks. For example, studies have shown that depleted CoQ10 can lead to loss of heart muscle function known as diabetic cardiomyopathy.12,16 Diabetics also have poor endothelial (blood vessel lining) function, which can be worsened by statin therapy, again as a result of CoQ10 depletion.17
Supplementing with 200 mg of CoQ10 per day has been shown to significantly improve diabetes-induced loss of endothelial function, illustrating the protective effect of simple CoQ10 supplementation.17
In addition, previous studies have shown that lipophilic statins, such as simvastatin, reduce the GLUT4 protein levels in adipocytes, whereas hydrophilic statins (pravastatin) do not. GLUT4 plays an important role in controlling blood glucose. Reductions in the expression of GLUT4 can contribute to insulin resistance and consequently the onset of type II diabetes. In addition, previous studies have noted a reduction in CoQ10 levels when patients are using statins.
A 2013 study looked at the effects of simvastatin, pravastatin, and ezetimibe on GLUT4 in 3T3-L1 adipocytes. Compared to control, a significant decrease in relative intensity of GLUT4 protein by approximately 36% was observed when adipocytes were treated with simvastatin. Pravastatin and ezetimibe did not statistically alter the relative intensity of GLUT4 protein, whereas ezetimibe + simvastatin significantly reduced the relative intensity of GLUT4 protein.15
This study suggests that lipophilic statins (simvastatin) reduce the GLUT4 protein levels in adipocytes, whereas hydrophilic statins (pravastatin) do not. Co-treatment with CoQ10 appears to prevent the reduction in GLUT4 protein levels caused by simvastatin.
While cholesterol-lowering statin drugs have been shown beneficial for reducing cardiovascular risk, use of high potency/high dosage statin drugs in older patients appears to increase the risk of developing type II diabetes.
One reason statins increase the risk of diabetes is because they deplete the body of CoQ10. Fortunately, studies suggest that supplementing with CoQ10 may help reduce the metabolic risks associated with statin therapy.
Diabetics who supplement with CoQ10 have also shown improvements in blood sugar and other measures, suggesting the multiple benefits of CoQ10 supplementation for statin users.
If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.
- Cholesterol Treatment Trialists C, Baigent C, Blackwell L, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010;376(9753):1670-81.
- Khalil MS, Khamis N, Al-Drees A, et al. Does coenzyme-Q have a protective effect against atorvastatin induced myopathy? A histopathological and immunohistochemical study in albino rats. Histol Histopathol. 2015;30(3):383-90.
- Duan X, Chen CF. Does coenzyme Q10 play a role in the risk of new-onset diabetes due to statins? Int J Cardiol. 2016;225:260-1.
- Brault M, Ray J, Gomez YH, et al. Statin treatment and new-onset diabetes: a review of proposed mechanisms. Metabolism. 2014;63(6):735-45.
- Carter AA, Gomes T, Camacho X, et al. Risk of incident diabetes among patients treated with statins: population based study. Bmj. 2013;346:f2610.
- Chan DC, Pang J, Watts GF. Pathogenesis and management of the diabetogenic effect of statins: a role for adiponectin and coenzyme Q10? Curr Atheroscler Rep. 2015;17(1):472.
- Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-207.
- Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375(9716):735-42.
- Preiss D, Seshasai SR, Welsh P, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA. 2011;305(24):2556-64.
- Available at: http://www.heart.org/HEARTORG/Conditions/More/Diabetes/WhyDiabetesMatters/Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp. Accessed February 7, 2017.
- Ridker PM, Pradhan A, MacFadyen JG, et al. Cardiovascular benefits and diabetes risks of statin therapy in primary prevention: an analysis from the JUPITER trial. Lancet. 2012;380(9841):565-71.
- Miyake Y, Shouzu A, Nishikawa M, et al. Effect of treatment with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on serum coenzyme Q10 in diabetic patients. Arzneimittelforschung. 1999;49(4):324-9.
- Swerdlow DI, Preiss D, Kuchenbaecker KB, et al. HMG-coenzyme A reductase inhibition, type 2 diabetes, and bodyweight: evidence from genetic analysis and randomised trials. Lancet. 2015;385(9965):351-61.
- Shen Q, Pierce JD. Supplementation of Coenzyme Q10 among Patients with Type 2 Diabetes Mellitus. Healthcare (Basel). 2015;3(2):296-309.
- Ganesan S, Ito MK. Coenzyme Q10 ameliorates the reduction in GLUT4 transporter expression induced by simvastatin in 3T3-L1 adipocytes. Metab Syndr Relat Disord. 2013;11(4):251-5.
- Garrido-Maraver J, Cordero MD, Oropesa-Avila M, et al. Coenzyme q10 therapy. Mol Syndromol. 2014;5(3-4):187-97.
- Hamilton SJ, Chew GT, Watts GF. Coenzyme Q10 improves endothelial dysfunction in statin-treated type 2 diabetic patients. Diabetes Care. 2009;32(5):810-2.