How NAD+ Supports Diabetes Prevention
How NAD+ Supports Diabetes Prevention
Type 2 diabetes is a chronic metabolic condition that develops due to a complex interaction between lifestyle, genetic, and environmental factors. It occurs when the body cannot use insulin properly or make enough insulin. The result is high blood glucose, also known as blood sugar, and if left untreated, it can cause serious health problems, such as heart disease, kidney disease, vision loss, and nerve-ending damage (1).
Diabetes is more common as people age, so it is often called a disease of aging. It can significantly affect individual health and wellbeing.
While there is no cure for diabetes, researchers have long been aware of the role of NAD+ in cellular metabolism and repair. Recently, researchers have been interested in how NAD+ levels respond to type 2 diabetes and how NAD+ supplementation may impact type 2 diabetes management.
In this article, you’ll learn about the most recent research about the role of NAD+ in type 2 diabetes development, prevention, and management. We will also introduce you to new research that suggests NAD+ may potentially reverse diabetes.
What Happens to NAD+ Levels with Diabetes?
People living with type 2 diabetes have multiple biochemical abnormalities, which are irregularities in essential blood chemicals and components.
The most well-known abnormality in blood glucose. If insulin levels are low or If the body doesn’t respond to insulin as it should, there is a danger of developing hyperglycemia or blood glucose levels that are too high. If people with diabetes go too long without eating, take too much insulin, or over-exerts themselves, they can develop hypoglycemia or too little glucose (1).
Another biochemical irregularity in people with type 2 diabetes is low NAD+ concentrations in cells and tissues. In fact, since NAD+ is a central component of the body’s normal metabolism, deranged NAD+ regulation and problems with related cellular functions are always present in people with type 2 diabetes (2).
Type 2 diabetes inhibits the function of chemicals that regulate bodily energy (3). The low NAD+ levels directly result from the oxidation of too much glucose and other components in the blood, namely free fatty acids and lactate. This partially contributes to low energy in people living with type 2 diabetes.
The Role of NAD+ in Diabetes Prevention
Pre-diabetes is when blood glucose levels are higher than usual, indicating altered glucose metabolism. However, when the condition is detected as prediabetes and individuals follow through with proper treatment and lifestyle changes, type 2 diabetes can be prevented.
Lab research with mice with pre-diabetes has found that nicotinamide riboside (NR) can help to improve glucose tolerance (4).
The Potential Role of NAD+ in Diabetes Management
NAD+ levels are low in people living with type 2 diabetes. Thus, researchers have suggested that replenishing NAD+ levels with NAD+ supplements and precursors can help manage, slow, and even halt the development of metabolic disorders such as type 2 diabetes (5). To cite one laboratory study, “In T2D mice, NR greatly reduced non-fasting and fasting blood glucose, weight gain, and hepatic steatosis while protecting against diabetic neuropathy.”
NAD+ supplements may help regulate energy metabolism in cells and maximize cellular efficiency. However, NAD+ supplementation in people with type 2 diabetes may also increase levels of oxidative stress. Research suggests that people with type 2 diabetes can take NAD+ and NAD+ precursor supplements with other medications and supplements to maximize the benefit of NAD+ supplementation and minimize the risk. Supplements and medications may include insulin sensitizers, aldose reductase inhibitors, polyphenols, and Acetyl-L Carnitine (3).
A lab study with wild mice helped illustrate one of the potential roles of NAD+ supplementation in helping to reduce diabetes complications. Researchers found that enhancing the poor of NAD+ in the blood with NAD+ precursors increased the NAD+ concentration in heart and vascular system cells, which allowed wound healing and blood flow in diabetic mice. These results suggest that NAD+ can help prevent damage caused to the cardiovascular system (6).
Reviews of human clinical trials also report positive results. Supplementation with NR, a key NAD+ precursor, is safe, well-tolerated, and can efficiently increase NAD levels in healthy volunteers (7). However, the efficacy of NAD+ supplementation as a treatment for metabolic diseases like type 2 diabetes has had unclear results, and more studies are needed.
Can NAD+ Reverse Diabetes?
While there is inconclusive guidance on NAD+ and NAD+ precursor supplementation for diabetes prevention, the initial evidence points to a relatively straightforward relationship between increased NAD+ levels through supplementation and lifestyle and improved outcomes in people with type 2 diabetes.
Supplementation with the NAD+ precursor nicotinamide mono nucleotide (NMN) helped blood glucose levels in diabetic mice return not normal, especially in female mice (8). But, can increased NAD+ levels reverse diabetes? Initial research suggests that it may.
The results have yet to be replicated in humans, but these initial findings are promising.
Main Takeaways
NAD+ concentrations are notoriously low in people with a type 2 diabetes diagnosis. This can contribute to symptoms and complications such as low energy, slower healing, and higher rates of cellular damage. However, initial research suggests that replenishing NAD+ levels through NAD+ supplementation and supplementation with NAD+ precursors may support the body in treating and managing type 2 diabetes symptoms.
However, it is crucial to keep in mind that NAD+ research on the role of NAD+ supplementation in humans in type 2 diabetes is still in the early stages, and NAD+ supplementation in people with type 2 diabetes may not be suitable for everyone living with type to diabetes.
Suppose you and your physician decide that NAD+ supplementation will support you in managing symptoms. In that case, it is essential to note that replenishment will likely need to be accompanied by other medications and supplements. Everybody is different. To receive personalized recommendations for your medical condition, you must speak to your healthcare team about taking NAD+ supplements.
References
1. Center for Disease Control. (2021, November 16). What is Diabetes? Centers for Disease Control and Prevention. Retrieved December 20, 2021, from https://www.cdc.gov/diabetes/basics/diabetes.html
2. Elhassan, Y. S., Philp, A. A., & Lavery, G. G. (2017). Targeting NAD+ in Metabolic Disease: New Insights Into an Old Molecule. Journal of the Endocrine Society, 1(7), 816–835. https://doi.org/10.1210/js.2017-00092
3. Fan, L., Cacicedo, J. M., & Ido, Y. (2020). Impaired nicotinamide adenine dinucleotide (NAD+) metabolism in diabetes and diabetic tissues: Implications for nicotinamide‐related compound treatment. Journal of Diabetes Investigation, 11(6), 1403–1419. https://doi.org/10.1111/jdi.13303
4. Trammell, S. A., Weidemann, B. J., Chadda, A., Yorek, M. S., Holmes, A., Coppey, L. J., Obrosov, A., Kardon, R. H., Yorek, M. A., & Brenner, C. (2016). Nicotinamide Riboside Opposes Type 2 Diabetes and Neuropathy in Mice. Scientific Reports, 6(1). https://doi.org/10.1038/srep26933
5. Elhassan, Y. S., Philp, A. A., & Lavery, G. G. (2017b). Targeting NAD+ in Metabolic Disease: New Insights Into an Old Molecule. Journal of the Endocrine Society, 1(7), 816–835. https://doi.org/10.1210/js.2017-00092
6. Wang, P., Yang, X., Zhang, Z., Song, J., Guan, Y. F., Zou, D. J., & Miao, C. Y. (2016). Depletion of NAD pool contributes to impairment of endothelial progenitor cell mobilization in diabetes. Metabolism, 65(6), 852–862. https://doi.org/10.1016/j.metabol.2016.03.006
7. Okabe, K., Yaku, K., Tobe, K., & Nakagawa, T. (2019). Implications of altered NAD metabolism in metabolic disorders. Journal of Biomedical Science, 26(1). https://doi.org/10.1186/s12929-019-0527-8
8. Yoshino, J., Mills, K., Yoon, M., & Imai, S. I. (2011). Nicotinamide Mononucleotide, a Key NAD+ Intermediate, Treats the Pathophysiology of Diet- and Age-Induced Diabetes in Mice. Cell Metabolism, 14(4), 528–536. https://doi.org/10.1016/j.cmet.2011.08.014