ESR1 and Hyperglycemia: Prolonged hyperglycemia can cause oxidative stress in β cells.35 E2 can prevent acute oxidative injury in β-cells in a hyperglycemic state by suppressing the β-cell translocation gene 2 (BTG2)-p53-Bax pathway.36 ERα localization in pancreatic β cells shows that E2 can confer protective effects against oxidative stress directly on β cells37 and additionally in hepatocytes38 to prevent insulin-deficient diabetes.