SIRT1 and cardiac hypertrophy: In other words, diabetes may lead to the activation of Akt/mTORC1 and the inhibition of SIRT1/PGC-1α/FGF21 through hyperinsulinemia, thereby inhibiting autophagic flux and promoting oxidative stress and mitochondrial dysfunction of diabetic myocardial cells, and thus promoting pathological cardiac hypertrophy.