Effects of nicotinamide mononucleotide on older patients with diabetes and impaired physical performance: A prospective, placebo‐controlled, double‐blind study

Abstract

Objective: Nicotinamide adenine dinucleotide regulates various biological processes. Nicotinamide mononucleotide (NMN) increases its intracellular levels and counteracts ageassociated changes in animal models. We investigated the safety and efficacy of oral nicotinamide mononucleotide supplementation in older patients with diabetes and impaired physical performance. Method:We carried out a 24-week placebo-controlled, double-blinded study of male patients with diabetes aged ≥65 years with reduced grip strength (<26 kg) or walking speed (<1.0 m/s). The primary end-points were to determine the safety of NMN oral administration (250 mg/day), and changes in grip strength and walking speed. The secondary end-points were to determine the changes in various exploratory indicators.Results: We studied 14 participants aged 81.1 AE 6.4 years. NMN was tolerable without any severe adverse events. The changes in grip strength and walking speed showed no difference between the two groups: 1.25 kg (95% confidence interval À2.31 to 4.81) and 0.033 m/s (À0.021 to 0.087) in the NMN group, and À0.44 kg (À4.15 to 3.26) and 0.014 m/s (À0.16 to À0.13) in the placebo group, respectively. There were no significant differences in any exploratory indicators between the two groups. However, improved prevalence of frailty in the NMN group (P = 0.066) and different changes in central retinal thickness between the two groups (P = 0.051) was observed. Conclusion:In older male patients with diabetes and impaired physical performance, NMN supplementation for 24 weeks was safe, but did not improve grip strength and walking speed.

Nicotinamide Mononucleotide Supplementation: Understanding Metabolic Variability and Clinical Implications

“…While some studies report improved gait speed, grip strength, and lower limb function [ 66 , 97 ], others show no significant effects on walking distance or in diabetic/obese populations [ 90 , 93 , 98 ]. Interestingly, NMN can improve muscle insulin sensitivity without impacting mitochondrial function or overall performance [ 55 ], suggesting a more nuanced effect on muscle health.…”

Apigenin: a natural molecule at the intersection of sleep and aging

“…Nicotinamide mononucleotide, a precursor to NAD + , was reported to be safe and well-tolerated ( 116 ), increase NAD + levels ( 117 ), augment insulin sensitivity in muscle ( 118 ), enhance energy ( 119 ), and reduce blood pressure ( 120 ). Nicotinamide mononucleotide’s effects were found to be more mixed on grip strength ( 117 , 121 ) and walking ability ( 121 , 122 ). Nicotinamide riboside, another NAD + precursor reported to be safe and well-tolerated ( 123 ), was similarly shown to increase levels of NAD + ( 124 ).…”

Nicotinamide Mononucleotide: Deciphering Metabolic Complexities for Improved Health Outcomes

“…While some studies report improved gait speed, grip strength, and lower limb function [98,125], others show no significant effects on walking distance or in diabetic/obese populations [119,122,127]. Interestingly, NMN can improve muscle insulin sensitivity without impacting mitochondrial function or overall performance [56], suggesting a more nuanced effect on muscle health.…”