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High NNMT expression is closely associated with glucose dysregulation: excessive NNMT activation disrupts nicotinamide metabolism, lowers NAD+ levels, impairs insulin signaling, reduces cellular glucose uptake and utilization, and promotes hyperglycemia and insulin resistance

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Examples of these health conditions include those with a lack of stomach acid, those who have undergone bariatric surgery, anemia caused by the inability to absorb the vitamin, other autoimmune digestive diseases, as well as several medications

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