Figure 12.

Proposed treatments to correct nicotinamide adenine dinucleotide (NAD⁺) levels in diabetes. Figure 7 showed abnormalities of NAD⁺ metabolism occurring in diabetes. To correct these abnormalities, proposed regimens are: (1) metformin, sodium–glucose cotransporter 2 (SGLT2) inhibitor, glucagon‐like peptide‐1 (GLP‐1); (ii) resveratrol, other polyphenols or sirtuin‐activating compoundssirtuin‐activating compounds (STACs) to activate sirtuin 1 (SIRT1)–adenosine monophosphate‐activated protein kinase (AMPK) for type 2 diabetes; (iii) benfotiamine to boost substrate (phosphoribosyl diphosphate [PRPP]) production; (iv) acetyl‐L‐carnitine to block diacylglycerol (DAG) production and lipotoxicity; and (v) aldose reductase inhibitor if glucose control is inadequate. 2‐PY, N‐methyl‐2‐pyridone‐5‐carboxamide; Akt, protein kinase B; AMPK, AMP‐activated protein kianse; ATP, adenosine triphosphate; DNA, deoxyribonucleic acid; LKB1, liver kinase B1; NMN, nicotinamide mononucleotide; NMNAT, nicotinamide mononucleotide adenylyltransferase; NNM, nicotinamide n‐methyltransferase; PPi, pyrophosphate; PPP, pentose phosphate pathway; R‐5‐P, ribose‐5‐P; ROS, reactive oxygen species.