In particular, it was verified that activation of the phosphatidylinositol-3 kinase/Akt (PI3K/Akt) signaling pathway is involved in both inflammatory processes and obesity.(10) We assume all these mechanisms can be interconnected, especially in the pathogenesis of DPN, and the key point may be activation of BDNF-TrkB system. The gene discussed is BDNF; the disease is obesity due to melanocortin 4 receptor deficiency.