Introduction
India has long been labelled the soon to become diabetes capital or nation of the world, with incidence rates just below China. Over 77 million people suffer from Type 2 diabetes while less than 30 million are prediabetic, which means it is only a matter of time before they become diabetic too, unless they make serious changes to their lifestyle and manage to delay it somehow. Ozempic is a well known therapeutic drug that is used to treat Type 2 Diabetes and is produced by Novo Nordisk, a Danish pharmaceutical company. More recently though, this drug which is a type of semaglutide- which means it helps the pancreas release insulin as needed, helps food digest slowly and also regulates glucose release by the liver - has been used to help individuals treat obesity, as it assists in weight loss. However, the brand names are different. Recent studies have shown that taking liraglutide, which is structurally quite similar to semaglutide can help reduce blood glucose levels, improve bone formation and mass and lead to weight loss.
What Drugs Like Liraglutide Or Ozempic Can Do
Liraglutide or semaglutide- both are classes of drugs called GLP-1 (Glucagon like Protein-1) agonists- which means they mimic the action of the GLP1 receptor. People who suffer from Type 2 Diabetes have enough insulin being made, but it is not able to enter cells effectively, as there is some issue with the number of GLP1 receptors on cells. Normally, GLP-1 helps sense glucose levels in blood and will signal to the pancreas to increase insulin production, while also helping reduce glucagon (a protein that helps blood glucose levels increase) activity at the same time. But, in Type 2 diabetes, this mechanism is messed up, leading to high blood glucose levels, less satiety and blood glucose spikes, among other issues. Liraglutide works in almost the same way as a semaglutide, except it needs to be taken everyday, while a semaglutide can be taken once a week. It also has the additional ability to reduce chronic inflammation by using SIRT-1 controlled pathways in cells. SIRT-1 is a well known sirtuin protein- a class of 7 proteins labelled from SIRT-1-7 respectively, which help in cellular repair and are protective in nature. Sirtuins need plenty of NAD+ to work their magic- and levels of NAD+ begin to reduce with increasing age.
The Experiment
Chinese researchers conducted experiments on diabetic mice models, which were then treated with 0.2mg/kg liraglutide, for a duration of 12 weeks. This helped reduce their blood glucose levels and body weight too. It was also observed that liraglutide helped increase bone mass and formation, and this was confirmed with tests that showed bone breakdown markers were lower than before. This happened mainly due to an increase in SIRT-1 activity.
Now, the researchers genetically modified the mice to NOT produce SIRT1 protein at all, but continued treating them with liraglutide injections as before. They noticed that without SIRT-1 activation, there were greater levels of oxidative stress and inflammation- which directly impacted bone mass and formation. This helped them confirm that SIRT-1 was indeed being activated by liraglutide.
What Happens With NMN Supplementation
With that experimental result in mind, let us explore one more concept- how NAD+ from NMN helps regulate all of this and increases longevity related markers in cells. Nicotinamide Mononucleotide, shortened to NMN is a compound that acts like a precursor to NAD+ - which is the energy currency of the mitochondria. If more NAD+ is present, the mitochondria works very efficiently and helps provide enough energy to run all cellular processes in real time. But, as someone ages, their NAD+ levels begin to drop, and they feel fatigued and suffer from chronic illnesses more often than not. Sirtuin activation also plummets as they are highly dependent on NAD+ for their energy needs.
So, if we supplement liraglutide or semaglutide therapy with NMN, then there could be weight loss and better blood glucose control because of the liraglutide, while other chronic inflammatory and aging related markers can be downregulated (or reduced) due to better activation of sirtuins by ample NAD+ derived from NMN. Though this drug combination still needs to be experimented with, it is not too hard to postulate what may happen- as research has definitively shown that NMN supplementation helps increase sirtuin activation in the body and that NMN can be combined with sirtuin activator drugs themselves for an additive therapeutic effect.
Conclusion
The renowned Australian aging researcher Dr. David Sinclair says this “I believe that aging is a disease. I believe it is treatable. I believe we can treat it within our lifetimes. And in doing so, I believe, everything we know about human health will be fundamentally changed.’ Though, all of us want to live long lives, we may not be able to do that because of the concerted effects of aging related pathways in the body. The use of liraglutide and semaglutide for treatment of obesity and diabetes is now well known. Quick weight loss can be stressful for the body and so supplementing with NMN may help offset some of these issues. With improvement in blood glucose levels and lower chronic inflammation, the person may also feel better than ever. So, what do you think would happen if sirtuin activators, NMN and liraglutide or semaglutide were used in combination to treat diabetes or obesity?


