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NAD is also a substrate for cellular signalling enzymes (sirtuins) and DNA repair enzymes (PARPs)

"Efficacy and safety of incretin co-agonists: Transformative advances in cardiometabolic healthcare"

The TGA says using these products raises significant regulatory and public health risks, stating it is actively monitoring this issue from both safety and law enforcement perspectives

According to KFF analysis of Centers for Medicare & Medicaid Services 2018-2022 Medicare Part D spending by drug increased from $57 Million to $5.7 Billion.[2] The June 13, 2024 article in Fierce Healthcare[3] on GLP-1 drugs noted that Blue Cross Blue Shield of Michigan will no longer cover these drugs starting in January 2025, and will be changing the prior authorization criteria starting in August 2024, for those members that are in large group fully insured commercial plans

The opposing effects on blood glucose could create unpredictable glycaemic fluctuations, particularly in individuals with pre-existing diabetes or impaired glucose tolerance