SMAD2 and diabetic cardiomyopathy: It is now clear that THBS1 is one of the most important physiological activators of TGF-β1, and research has shown that the THBS1-activated TGF-β1/Smad2/3 signaling pathway may play an important role in the development of myocardial interstitial fibrosis in diabetic cardiomyopathy [47].