NAD Augmentation in Diabetes Kidney Disease

Who May Qualify: 1. Has T2DM, as indicated by any of the following: 1. Self-report of diabetes plus the use of a prescribed diabetes medication. 2. ICD-10 code for diabetes plus current use of a diabetes medication in the electronic medical record. 3. HbA1c \>6.4%; or 2 fasting glucose \> 125 mg/dL 2. Fasting morning UACR between 100 and 2,000 mg/g creatinine on two separate days 3. If UACR is \> 300 mg/g creatinine, must be currently using an ACE inhibitor or an ARB 4. eGFR \> 30 mL/ min / 1.73 m2 5. Hemoglobin A1c \<9% 6. Able to speak English or Spanish 7. Willing and able to provide written willing to sign a consent form 8. In addition, female participants must Not be pregnant and not planning to become pregnant over the next 6 months Who Should NOT Join This Trial: 1. Fasting morning UACR \> 2,000 mg/ g creatinine 2. Other laboratory abnormalities: 1. Has AST or ALT \> 3 times the upper limit of normal 2. creatinine \> 2.5 mg/dL 3. Hematocrit \< 0.34 or 0.50 L/L 3. A major adverse cardiovascular event in preceding 3 months 4. Participation in an investigational trial to evaluate pharmaceuticals or biologics within the past 3 months or 5 half-lives, whichever is shorter 5. Hypoglycemia unawareness or other medical conditions which could jeopardize participant's safety. 6. History of alcohol or substance use disorder or dependence (DSM 5 criteria) within the last 2 years. 7. Major depressive disorder, bipolar disorder, schizophrenia, or current psychotic symptoms or behavioral problems that could interfere with study procedures. 8. BMI \> 42.5 kg/ m2 Always talk to your doctor about whether this trial is right for you.