During hyperglycaemia and dyslipidaemia, dysregulation of macroautophagy [1] (hereafter referred to as ‘autophagy’) and AMP-activated protein kinase (AMPK) [1–3] is associated with endothelial cell damage and dysfunction, events that often precede atherogenesis [4,5]. The gene discussed is PRKAA1; the disease is inherited lipid metabolism disorder.