In addition, melatonin showed its protective capability on myocardial cells in type 2 diabetic rats by reducing oxidative stress and ER stress (induced by the elevated blood glucose) through the activation of SIRT1 signaling pathway and inactivation of protein kinase-like endoplasmic reticulum kinase (PERK)/eukaryotic translation initiation factor 2 (eIF2α)/ATF4 (activating transcription factor 4) signaling pathway [276]. This evidence concerns the gene ATF4 and type 2 diabetes mellitus.