| Outcome Measures: |
Primary: The primary endpoint is the change from baseline in UACR over the 6-month intervention period., To determine whether treatment with a microcrystalline formulation of β nicotinamide mononucleotide (βNMN) in older adults with DKD improves urinary albumin to creatinine excretion ratio (UACR), compared to placebo., 6 months | Secondary: Assess the proportion of participants in the two study arms with 30% or greater reduction in UACR, In supportive analysis of the primary outcome, the investigator will compare the proportion of participants in the two study arms with 30% or greater reduction in UACR, 6 months|Assess the change from baseline over the 6-month intervention period in biomarkers of kidney injury., Compared to placebo treatment, NMN treatment of older adults with DKD will assess for improvements in biomarkers of kidney injury in association with DKD prognosis by measuring KIM-1 and STNFR1 combinedly., 6 month|Change from baseline in the levels of serum creatinine over 6-month intervention period, To determine whether NMN treatment is associated with change in serum creatinine from baseline to 24 weeks between the two study arms., 6 month|Change from baseline in the levels of cystine C over 6-month intervention period., To determine whether NMN treatment is associated with change in cystatin C from baseline to 24 weeks between the two study arms., 6 month|To determine whether NMN treatment is associated with significantly greater improvement in muscle endurance., Assess the change from baseline in muscle endurance by exercises (reps to failure) using Keiser Machines, 6 month|Assess the change from baseline in performance-based measures of function., To determine whether NMN treatment is associated with significantly greater improvement in performance based by using 6-minute walking distance measure of function., 6 month|To determine whether NMN alters the circulating biomarkers of aging that the geroscience experts have recommended., Compared to placebo treatment, NMN treatment will be assessed to identify greater changes in the circulating biomarkers of aging. the biomarkers that will be assessed are IL6 and TNFalpha, 6 months|Assess the change from baseline in the levels of NMN in the peripheral blood and in the PBMCs using a validated LC-MS/MS assay., NMN treatment will be assessed to determine significant increases in blood levels of NAD and its metabolome during the 24-week intervention period. The increase in NAD levels are to be observed during the intervention period in NMN-treated subjects that will be sustained during the 12-week follow-up period (legacy effect)., 6 months|Assess the change in measure of H1bac as a measure of glycemic control over the 6 months intervention period., To determine the effect of NMN treatment on Hb1ac (expressed in mg/dL) in the body as a measure of glycemic control., 6 months|Assess the change in measure of fasting glucose as a measure of glycemic control over the 6 months intervention period., To determine the effect of NMN treatment on fasting glucose in the body as a measure of glycemic control., 6 months
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