INS and familial dilated cardiomyopathy: Once DCM is established, cardiac insulin metabolic signalling is impaired in addition to reduced Akt phosphorylation.7, 45 Our data showed that kirenol treatment at high doses could not only reduce high insulin levels in circulation but also promote phosphorylated Akt activation in the diabetic myocardium of GK rats without intraperitoneal injection of insulin, while GK rats that did not receive kirenol gavage exhibited an obvious defect in response to insulin exposure.