In summary, evaluating the degree of cardiac fibrosis using non-invasive imaging techniques and reversing cardiac fibrosis using precision therapeutic strategies that eliminate cardiac fibrosis by blocking the activation of the ROS system, AGE-mediated ET-1, the ECM receptor pathway, or the TGF-β pathway induced by hyperglycemia in DM cardiomyopathy can help improve LV diastolic function and prevent the progression of HFrEF in patients with DM cardiomyopathy (Figure 3). The gene discussed is TGFB1; the disease is Hyperglycemia.