CYP8B1 and Hyperglycemia: Also, insulin resistance is associated with Foxo-1-mediated downregulation of CYP8B1 resulting in depletion of 12α-hydroxylated bile acid pool, which may be explained by hyperglycemia-induced Foxo degradation, and therefore a lack to activate CYP8B1, whereas in type 2 diabetic patients concentration of DCA has been found to be elevated (Brufau et al., 2010; Haeusler et al., 2013).