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Secondly, NAMPT expression is decreased because of reduced AMPK activity which occurs in type 2 diabetes. The AMPK inhibition is caused by an activation of protein kinase C and D1 due to enhanced diacylglycerol synthesis caused by pseudohypoxia and increased fatty acids levels. In this regard, nicotinamide-related compounds should be given with caution to treat diabetes. To minimize the risk and maximize the benefit, nicotinamide-related compounds should be taken with insulin sensitizers (for type 2 diabetes), polyphenols, benfotiamine