2010). This key enzyme is effectively inhibited by malonylCoA, whose concentration is dependent on blood insulin levels (Awan and Saggerson 1993). In diabetes, more malonylCoA is decarboxylated leading to a decreased concentration of malonylCoA in diabetic myocardium and thus less inhibition of CAT-1 (see Fig.1D) (Lopaschuk et al. 2010). This has led us to hypothesize that myocardial conversion of acetate to ALCAR might be increased in diabetes. As mentioned above, the consumption of acetate was reported to be reduced in diabetic kidneys (Shreve et al. 1995). Here, INS is linked to diabetes mellitus.