Moreover, hyperglycemia and hyperlipidemia in diabetes lead to increased oxidative stress and DNA damage, which is followed by activation of the P53 molecule, a nuclear regulating factor for the expression of genes related to cell survival and death that participate in diabetes-induced cardiac damage47,48 and regulate the expression of Bax and ICAM1. 49 The prominent results of the current study demonstrated that in fenugreek extract and metformin treated groups, the gene expression of Bax and ICAM1 was decreased, while Bcl2 overexpression was observed. Here, ICAM1 is linked to hyperlipidemia.