This dephosphorylation and activation of PDH is impaired in in the diabetic heart.5 In the diabetic heart impaired insulin signalling furthermore leads to inhibition of PDH activity through upregulation of PDH kinases.6 Inactivation of PDH with continued flux through glycolysis controls the switch between aerobic and anaerobic glucose metabolism, which occurs, for example, in cardiac ischemia.7 The gene discussed is PDP1; the disease is myocardial ischemia.