As the intracellular elevation of glucose leads to the accumulation of methylglyoxal, it is likely that methylglyoxal contributes to the increase in Nrf2 and Nrf2 targets NQO1 and HO-1 that has been observed in diabetes without [125,126] and with DKD [37,54,125,126,127,128]. This evidence concerns the gene NFE2L2 and diabetic kidney disease.