Therefore, we hypothesized that a triple combination therapy of ALA, gliclazide (a commonly used anti-diabetic drug) and ramipril (a cardioprotective and blood pressure-control agent) could increase myocardial antioxidant status and suppress cardiac fibrosis via inhibition of TGF-β1/Smad pathway in a rat model of DCM in T2DM. Here, TGFB1 is linked to familial dilated cardiomyopathy.