SIRT1 and diabetes mellitus: SRT2104, which is a novel, first-in-class, highly selective small-molecule activator of SIRT1 can enhanced renal SIRT1 expression and activity, deacetylated P53, and activated NRF2 antioxidant signaling, providing remarkable protection against the DM-induced renal oxidative stress, inflammation, fibrosis, glomerular remodeling, and albuminuria in the diabetic mice models.[29] Serum HIF-1α may be involved in DKD process through inflammation, angiogenesis, and endothelial injury.[30] However, the signal pathway is unknown.