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et al., 2007)

The system gets flooded with NAD+ at levels up to ten times higher than normal, which raises concerns about: Potential mitochondrial dysfunction Possible sirtuin overactivation Disruption of methylation processes [8] NAD+ at very high levels may block poly(ADP-ribose) polymerases (PARPs) and possibly compromise DNA repair mechanisms [8]

Incretin action of GIP is dramatically reduced in the presence of diabetes, as demonstrated by the evidence that glucose-dependent insulin secretion is not potentiated by GIP administration in subjects with diabetes [33, 34]