Inflammatory responses triggered by metformin (as well as by type 2 diabetes itself)69–71 further complicate the predictability of its effects on Hes3 expression because different inflammatory cytokines may have opposite effects on Hes3 expression (depending on whether they predominantly stimulate the JAK-STAT or Akt/mTOR pathways, for example). The gene discussed is AKT1; the disease is type 2 diabetes mellitus.