SERPINE1 and Hyperglycemia: Glutamine, fructose-6-phosphate amidotransferase, is the rate-limiting step of the hexosamine biosynthesis pathway, which activates as an alternative pathway to glycolysis for the utilization of hyperglycemia-induced overproduction of fructose-6-phosphate, resulting in excess of N-acetylglucosamine and irregular alteration of gene expression of plasminogen activator inhibitor-1 and TGF-β.