In a study of native American Indians with type 2 diabetes, we showed upregulation of renal acetyl-Co A carboxylase (ACC) encoding genes in association with increased circulating di- and triacylglycerols in progressors of diabetic kidney disease coupled with markers of impaired β-oxidation, suggesting that upregulation of de novo lipogenesis (DNL) might be an underpinning mechanism of diabetic kidney disease progression at an early stage [12]. The gene discussed is ACACA; the disease is diabetic kidney disease.