Further, diabetes-induced EMT is mediated primarily by the upregulation of TGF-β1, fibroblast-specific protein-1 (a key activator of EMT), and Snail (a transcriptional inducer of EMT) and the downregulation of nephrin, ZO-1, and P-cadherin6–8. This evidence concerns the gene TGFB1 and diabetes mellitus.