As suggested in Figure 3, high insulin at the beginning of diabetes up-regulates CD36 mRNA expression by activating the transcription factor forkhead box protein O1 (FOXO1) and strongly transports CD36 to sarcolemma by activating the PI3K-Akt pathway while chronic high glucose and high triglyceride (TG) in the advanced stage of diabetes further facilitate CD36 expression and sarcolemma distribution (48, 49). The gene discussed is INS; the disease is diabetes mellitus.