TGFB1 and Hyperglycemia: TGF-β activity can also be increased by high glucose-induced activation of transcriptional co-regulator p300 (Bugyei-Twum et al., 2014), sustained hyperglycemia (Wu et al., 2016; Xu et al., 2016), and activation of matrix metalloproteinases (MMP), a family of ECM proteolytic enzymes (Dayer and Stamenkovic, 2015; Li et al., 2018).